2921 HOYT AVE 2024-05-03 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATI gov C�C CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 K F 9 t. nr�^ W ASHINGIGN (P w.)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I wweverettwa ermits. Ut - - PROJECT SITE INFORMATION PROJECT ADDRESS: 2921 Hoyt Ave I Everett, WA 98201 US .BUILDING AREA: Jui VIG� PROJECT TYPE: ❑ NEW CONSTRUCTION A ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: 17 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 120 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Hook up power to one (1) new suspended blade sign c ,) er)Nl -, THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO ❑✓ YF -Select Scope: El Service ❑ Feeder ❑✓ Circuits-#:1 El Complete Re-wire LOW VOLTAGE WORK? El NO ..S-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data El Intercom ❑ Thermostat ❑ Audio El Secure Access ❑ 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. ❑✓ Other(List All):Sign 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: ONO 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: Artspace Everett Limited PartnerE TENANT BUSINESS NAME(If Commercial):Schack Art Center OWNER MAILING ADDRESS: STREET 250 Third Ave N Ste 500 CITY Minneapolis STATE MN zip 55401 OWNER PHONE:4257544380 OWNER EMAIL:mhagen@centralbodyworks.com CONTRACTOR NAME: Berry Sign CONTRACTOR ADDRESS: STRFET5002 S Washington St , Tacoma STATE WA zip 98409 CONTRACTOR PHONE:2538333600 CONTRACTOR EMAIL:mIkel@berrySign.COm CONTRACTOR LIC.#(REQUIRED):BERRYSS853w7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):603454590 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:M Lee CONTACT PHONE:2530232-5620 ike Lee CONTACT EMAIL:mIkel p@berrysign.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#: 3.7.2023 �: o � ! ,-5 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application