3706 RUCKER AVE 2022-01-21 - Laserfiche WebLink

mis LOECTRICAL PERMIT APPLIVTION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3706 Rucker Ave. BUILDING AREA: 30(work area) sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑✓ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ✓❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK , CONTRACT PRICE OF WORK: $ 2,200.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Installing new AES radio to existing fire alarm control panel for monitoring. THIS INSTALLATION INCLUDES THE 0 LO NG SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ N EYE -Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#: 1 ❑Complete Re-wire LOW VOLTAGE WORK? NO El Y S-#of Devices: SELECT SCOPE(REQUI ED): E ata Intercom ❑ Thermostat ❑ Audio ❑ Secure Access ❑ Security System ✓❑ F re Alarm- Installations under this permit only include electrical wiring rough-in of the system.An additional Fire arm Permit is required for review of device location and installation approval. CIther(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO ❑ YES--See Below&Pg. 2 ❑ 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. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: 'ENO EYES-See Below&Pg.3 ❑ 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 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: Berner Holdings LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3112 Rockerfeller Ave.cm �/��' Everett STATE •�A ZIP 98201 OWNER PHONE:- OWNER EMAIL:- CONTRACTOR NAME: Commercial Alarm & Detection CONTRACTOR ADDRESS: STREET 17199 Bennett Rd. CITY Mt. Vernon STATE WA ZIP 98273 CONTRACTOR PHONE:509-868-8485 CONTRACTOR EMAIL:ron@cfirepro.com CONTRACTOR LIC.#(REQUIRED):COMMEAI948LO CITY OF EVERETT BUSINESS LIC.#(REQUIRED) :3t ` ` PRIMARY CONTACT: DOWNER OCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-848-1533 X111 Krista Swanson CONTACT EMAIL:krista@cfirepro.com 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#: i 4 ,ci-- /l� E l2 "b ge O Auth rized Agent Signature (Revised 1/11/2019) P a a 1-Application