2525 RUCKER AVE 2023-06-22 - Laserfiche WebLink

ESCTRICAL PERMIT APPLIdDrION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR S rRE 't EVERETT,WA 98201 I 2;,2 5tX 425-257-8857 1(E)eveconeps4everettwa.gov 4.4.0t,4.h.,stotto TiON PROJECT ADDRESS: 2525 Rucker Ave. BUILDING AREA: 6;353 sq ft PROJECT TYPE: El NEW CONSTRUCTION 0 ADDITION El TENANT IMPROVMENT El REMODEL BUILDING USE: El SFR El TOWNHOUSE 171 DUPLEX El ADU El MULTI-FAMILY- s OF UNITS: 2 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 10,532.00 ASSOCIATED BUILDING PERMIT#(if applicable). DESCRIBE SCOPE OF WORK: Remodel existing bathroom and kitchen. Replace and add bathroom fixtures and occupancy sensors. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO CI YES-Select Scope:El Service 0 Feeder ' Circuits :_5 0 Complete Re-wire LOW VOLTAGE WORK? 171 NO [RYES-#of Devices: fb. SELECT SCOPE(REQUIRED): El Data 0 Intercom [73 Thermostat El Audio El Secure Access El Security System El 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, O:i' r Uist All) CODE COMPLIANCE , , IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: Nu YES -- &Pg.2 {:21By checking this boxt 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 L10ENSURE: NO OYES-See BelOw&Pg.3 — Pursuant to ROW 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 fern this licensing/certification re0iiiromeriL CONTA0t0IF9RMATION OWNER NAME: Salvation Army TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sines 2525 Rucker Ave. coy Everett STATE WA zlp 98201 OWNER PHONE:425-259-81 29 OWNER EMAIL: CONTRACTOR NAME: Bayview Electric CONTRACTOR ADDRESS: srpEET11777A Watertank Rd. cry Burlington ETAT r WA zip 98223 CONTRACTOR PHONE:380-707-0535 CONTRACTOR EMAIL: katelyno@bvelectric.net CONTRACTOR L1C.#(REQUIRED):BAYVIEL954NK CITY OF EVERETT BUSINESS LIC.#;'REQU1RED):054268 PRIMARY CONTACT: DOWNER OCONTRACTOR 00THER(Please Specify) CONTACT NAME: CONTACT PHONE:360-707-0535 Katelyn O'Hara CONTACT EMAIL:katelyno@bvelectric.net AGREEMENT:I hereby certify that I have read and examined This application and know the same to be true and correct. Ail provisions of laws and ordinances governing this type Of work will be completed whether specified herein or not The granting ore permit does nor presume to give authority to violate or cancel the provisions of any other slate or local law regulating construction or the performance of construction, That I am authonzed by the owner of this properly to perform the work for which application is made bad! comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC, City of Everett Official Use Only PERMIT#: 0* 12/04/2019 E / - Owner/Authorized Agent Signature Date (Revised 7/11/2019) Page 1-Application