2902 RUCKER AVE FAST SIGNS 2023-10-25

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1(E)PermitServices@everettwa.gov I wmv.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:2902 rocker Ave BUILDING AREA: 20000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT Q REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIA ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $18,400 ASSOCIATED BUILDING PERMIT#(if applicable):n/a DESCRIBE SCOPE OF WORK: Electric for new and relocated printing equipment in workroom 1110 Electric for new and relocated printing equipment in workroom 1110 Includes new 100 amp panel feeder for panel 1 K from panel 1 H THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO EYES-Select Scope:❑Service ❑✓ Feeder ✓❑Circuits-#: 14 ❑Complete Re wire LOW VOLTAGE WORK? ❑NO ❑✓ YES-#of Devices:20 SELECT SCOPE(REQUIRED): ❑✓ Data ❑Intercom ❑Thermostat ❑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): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: LINO 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:❑NO AYES-See Below&Pg. ❑ 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 NAMEPMT Rucker LLC TENANT BUSINESS NAME(If Commercial): Fast Signs Everett OWNER MAILING ADDRESS: STREET 2802 Colby Ave CITY Everett STATE wa ZIP 98201 OWNER PHONE:425-287-5316 OWNER EMAIL:john.mcbride@fastsigns.com CONTRACTOR NAME:Advanced Home Technologies, LLC (AHBT, LLC) CONTRACTOR ADDRESS: STREET4665 Welch Lane CITY Anacortes STATE WA ZIP 98221 CONTRACTOR PHONE:360-661-5576 CONTRACTOR EMAIL:rich@advhometechllc.com CONTRACTOR LIC.#(REQUIRED):advanht945bj CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 61257 PRIMARY CONTACT: DOWNER [E]CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-661-5576 Rich Johnson CONTACT EMAIL:rich@advhometechllc.com AGREEMENT:I hereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laves and ordinances governing this type of work v.111 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 theserfonnance of construction. That/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law f .27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: acO i H(Irl(1Q E -�U30 . t;- wnerlAuthorized Signature Date (Revised 4/5/2022) Page 1-Application