3209 ROCKEFELLER AVE 2020-01-30 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION T CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PR ECT SITE INFORMATION slis .../...V 5 7 v \51 PROJECT ADDRE .c PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 13-60iTIMERCIAL BUILDING AREA: ..5e°6 sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ /tZe,.e"i) ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? 0 NO GKES-#OF DEVICES: (l.5) IS THIS A FIRE ALARM PERMIT? 0 NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE , DESCRIPTION OF WORK: k 0 1-(-o..(t ('3) 'Fc,•-s- (_t 14-e-5 ( ( ) -T- k 4c ter(Sr en e,...AA-(1 (ci ) Ca-irc e )4, c .61 e S THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El By checking this box, I am stating that I have read and understand all of WAC 296-46B-900,selected the specific 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. ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: 0 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without the proper electrical licensing and certification,or exemption.By checking this box,I am stating that I have completed and signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: rj ...,)et_A- a 4-cJ TENANT BUSINESS NAME(If Commer " I): . .....„) OWNER MAILINGION2Et . , mS'-''-7zEE1- TOct Pocke-4/4'1- A-ac CITY .1/6,112-71/ STATE Ll'it"1/4.- - ZIP 97-2-d OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: .es.-Ce.4A- C--bl----‘7 331 C CONTRACTOR ADDRESS: STREET 50(14 1+0 y+ A°e'll•"--"P--- cm, V••el-t—tt STATE )....)ICA.... ZIP 5g2 of CONTRACTOR PHONE:'la'3P7-432.C I CONTRACTOR EMAIL: , C-k tic g' Cc4-I? geetCO 44 . C CONTRACTOR LIC.#(REQUIRED): SE4C..0c1-9Vziii CITY OF EVERETT BUSINESS LIC.#(REQ1_ ____ PRIMARY CONTACT: 0 OWNER ia-C-ONTRACTOR DI OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: yz c- cor- /4,, r e4d1.5 8 ei • CONTACT EMAIL: C..._by. .. ® Cel%tir.e et Co stA , c AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this 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 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# n M p i---jorized Agen ,o1 ‘/(telfpf,e --/Authi Signature Date( (Revised 10/30/2018) Page-l-ef-e•