3218 RUCKER AVE 2022-02-16 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHIHCiTOH (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa,gev j www.everettwa,gov/permits PROJECT SITE INFORMAJ ,.,: w,: ; 1 PROJECT ADDRESS: 3218 Rucker AVE Everett 98201 BUILDING AREA: sq ft PROJECT TYPE: O NEW CONSTRUCTION 0 ADDITION El TENANT IMPROVMENT 0 REMODEL BUILDING USE: CI SFR El TOWNHOUSE 0 DUPLEX O ADU El MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION ItiraRM. ' ,O 4t*OFA . :*it CONTRACT PRICE OF WORK:$ 1850 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Panel Change THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO O✓ YES-Select Scope: ✓O Service O Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? E NO O YES-#of Devices: SELECT SCOPE(REQUIRED}: El Data ❑Intercom 0 Thermostat O Audio ❑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): i1I �w �� 2* ,.. ,d a s CODE COMPLIANCEC IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑NO 0 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: ONO OYES-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:Walt Krein TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3218 Rucker AVE cn,, Everett STATE WA ZIP 98201 OWNER PHONE:na OWNER EMAIL: CONTRACTOR NAME: IN House Electric CONTRACTOR ADDRESS: sTREET1530 117th DR SE crrr Lake Stevens STATE WA 98258 CONTRACTOR PHONE:4257603203 CONTRACTOR EMAIL:ihepermits@gmail.com CONTRACTOR LIC.#(REQUIRED):inhoues952gg CITY OF EVERETT BUSINESS LIC.#(REQUIRED):044168 , PRIMARY CONTACT: DOWNER DCONTRACTOR JOTHER(Please Specify) CONTACT NAME: [CONTACT PHONE:4257603203 keisey CONTACT EMAIL:kelsevOinhouseelectric-corn , Dq1 Scanned with CamScanner