2532 ROCKEFELLER AVE 2021-04-01 - Laserfiche WebLink

i ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET.EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa gov I www.evereuwa gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2532 Rockefeller Ave BUILDING AREA: _sq ft PROJECT TYPE: ❑NEW CONSTRUCTION El ADDITION L.TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX [1]ADU ❑MULTI-FAMILY-#OF UNITS COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 3500 ASSOCIATED BUILDING PERMIT#(if applicable) DESCRIBE SCOPE OF WORK: In SW basement, remove existing rusty and corroded 200 amp subpanel and replace with new 200 amp subpanel THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: H Service ❑Feeder ❑Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED)• El Data ❑ Intercom ❑Thermostat ❑Audio ❑Secure Access El Security System LI 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 i _I Other(List Ali):,. .... _...... CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO 17 YES--See Below& Pg 2 / By checking this box,I am stating that I have read and understand all of WAC 256-46R-9O0,selected the specific reason on page 2 Y of this application fsee next page),AND Plan Review NOT requirred Decause I meet Bali of the following sub sections that do not See Page 2 require Plan Review, ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓❑NO LIVES-See Below&Pg 3 Pursuant to RC`vV 19,28,2.31,property owners and leaseholders cannel perfatm electrical work or buildings ftrr rent,sale,or;ease without the proper electrical licensing and cenificalion,or exemption By checking this box,I am stating that I 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: srReeT 2532 Rockefeller Ave cm. Everett STATE WA z,F 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 STATE WA zip 98036 CONTRACTOR PHONE:425•478-3991 CONTRACTOR EMAIL:eeelectriC@COmCaSt,flet CONTRACTOR LIC.#(REQUIRED):EEELEI"981„K — CITY OF EVERETT BUSINESS LIC.#(REQUIRED): E033 PRIMARY CONTACT: El OWNER (]CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 47$ 3991 JayEggebraaten�� CONTACT EMAIL:eeelectric@Comcast,net AGREEMENT,t mereby illy that 1 have=eat'aria'oarnreo'ilrr advaricatieri and Arrow lire same to he eve and correct All pro vrsrons of l es and write yii;,:es in Ah:.S 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 regulaating construction or the performance of construction Thal I am authorized by the owner of this property to perform ifie work for which application is made and I comply with the State Contractors Law 18 27 RCW and 295,200 WAC City of Everett Official Use Only PERMIT#' },4 (.0 OwnerlAuthorized Agehf Signature Date (Revised 1/11/2019) Page i•Apploratiun