2532 ROCKEFELLER AVE 2020-01-30 - Laserfiche WebLink

mem ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON Ii')425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa goy' www everellwa.govlpermits PROJECT SITE INFORMATION PROJECT ADDRESS: 2532 Rockefeller Ave BUILDING AREA: sq ft PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION TENANT IMPROVMENT ❑REMODEL .......... .._. BUILDING USE: ❑SFR El TOWNHOUSE 11 DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: IyJ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 3000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Remove (2) existing heaters and replace with (2) new heaters in foyer. Add (1) 15 amp circuit for (1) new heater in pastoral office. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#1 ❑ Complete Re-wire LOW VOLTAGE WORK? I❑✓ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): t_..1 Data ❑ Intercom ❑Thermostat El Audio El Secure Access ❑Security System ❑ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional Fire Alarm Permit is required for review of device location and installation approval. ❑Other(List All) CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 71 NO n YES--See Below&Pg 2 By checking this box, I am stnl.i;g that I have read and uhiSerStand att of WAC 295-46sB-500,selected the speclitc reason on page 2 of this application(See next page), AND Plan Review is NOT required because I meet all of the following Sub Sections that do not See Page 2 require Plan Review —t ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO tDYES-See Below& Pg 3 Pursuant to RCW 19.2 0.2-1 property owners and leeseholoers cannot perform electrical work on buildings for rent,sale,or lease 4 without the proper electrical licensing and certification,or exemption By checking this box,I ant stating haat t have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement CONTACT INFORMATION OWNER NAME: Calvary Lutheran Church TENANT BUSINESS NAME(If Commercial) Calvary Lutheran Church OWNER MAILING ADDRESS: STREET 2532 Rockefeller Ave ar Everett STATE WA ZIP 98201 OWNER PHONE:425-347-3546 OWNER EMAIL: Bill Fish CONTRACTOR NAME: E & E Electric, Inc. CONTRACTOR ADDRESS: STREET 23826 35th Ave W cm Brier MATE WA zip 98036 CONTRACTOR PHONE:425-478-3991 CONTRACTOR EMAIL:eeelectric@comcast.net CONTRACTOR LIC.#(REQUIRED);EEELEI"981JK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 60831 PRIMARY CONTACT: ❑OWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-478-3991 Jay Eggebraaten CONTACT EMAIL:eeelectric@comcast.net .AORETAteVT,r heretty certify that i ruiv*react arm',exarrmed this otovttron arnrf kilt=•M Pie same in be hoe and corioeL:-ilitprorisiroxfoffewsdhd erdoences g vemig 7ioi type of work will be completed whether specified herein or not The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296 200 WAC City of Everett Official Use Only PERMIT$1- i 1 cco **-,T414 IA. /11�gg 14,v°,-- 12/10/2019 E qi 2— OwTrerdAuth rizeclA )if Signature Dale (Revised 1/11/2019) Page 1-Application