2902 RUCKER AVE FAST SIGNS 2023-10-25

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINOYoN (P)425.257-8810 1(E)PermitServices@everettwa.gov I www.everettwe.gov/permits PROJECT ADDRESS:2902 Rucker Ave" BUILDING AREA: 17000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION []ADDITION QTENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ABU ❑MULTI-FAMILY-#OF UNITS: Q COMMERCIAL ELECTRICALAPPILICI>�TI;ON�INF, AMATION Ss I ESCI IPTION IF WOR C' CONTRACT PRICE OF WORK: $28,900-Y (lytotq I 0f�4SSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK:' add 100 amp sub panel and 12 circuits for equipment relocation add 100 amp sub panel and 12 circuits for equipment relocation THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO H YES-Select Scope:❑Service ❑✓ Feeder ❑Circuits-#: 12 ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑NO ❑YES-#of Devices: 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 Ail): GODS":COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO LJ YES--See Below Pg.2 ❑ By checking this box, I am stating that I have read and understand all of WAC 29641681-900,selected the specific reason on page 2 of this application(see next page),AND Pian Review is NOT required because I meet all of the following sub sections that do not See Page 2 require Pian Review. ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ✓NO ❑YES-See Below&Pg. ElPursuant 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. CONTAT:IROR11ilAT10N OWNER NAME:DMT Rucker LLC TENANT BUSINESS NAME(If Commercial : Fast sighs - everett OWNER MAILING ADDRESS: STREET 2902 Rucker Ave CITY Everett sT,, WA ZIP 98204 OWNER PHONE:Daniel Jolly OWNER EMAIL:daniel.jolly@fastsigns.com CONTRACTOR NAME:Advanced Home Technologies, lie CONTRACTOR ADDRESS: IT1 1IT4665 Welch Lane CITY anacortes STATE Wa ZIP 98221 CONTRACTOR PHONE:360-293-7004 CONTRACTOR EMAIL:rich@advhometechtic.com CONTRACTOR LIC.#(REQUIRED):ADVANHT945BJ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):61257 PRIMARY CONTACT: ❑OWNER EICONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: h CONTACT PHONE:360-661-5576 Richard JohnSCONTACT EMAIL:rich@advhometechllacom AGREEMENT:1 hereby certify that t 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 orlocal law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application is made and I comply wit the State Contractors Law 18.27 RCW and 295.200 WAC. City of Everett Official Use Only PERMIT#: ."5'2a-2,3 E i2o3-m ageQ q- lOwner/Aut ized Agent Signature Date (Revised 4/572022) Page 1-Application