2624 ROCKEFELLER AVE UNITED CHURCH OF CHRIST 2019-04-29

ELECTRICAL PPMIT & FIRE ALARM PEttl IT APPLICATION ,, CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits o 1.,"•:,-,,,, v,........4.:4„„„,-21,=, •u ' � s : : 1,' • t .� , w PROJECT ADDRESS: 2624 Rockefeller Ave. PROJECT TYPE: EJNEW CONSTRUCTION 0 ADDITION nTENANT IMPROVMENT EIREMODEL BUILDING USE: FR 0 TOWNHOUSE 0 0UPLEXDU 0 MULTI-FAMILY-#OF UNITS: i7a COMMERCIAL BUILDING AREA: N/A sq ft CONTRACT PRICE OF WORK:$790 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? IZI NO 0 DYES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? 0 NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) e\ ', . a �� iiiiitt, i x a s ....�.> iia: ��v . „.;«v` ... .•..... DESCRIPTION OF WORK: Run 40'of conduit and wire to new location for 2 flood lights near the front corner of the entrance courtyard. THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: (D 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 (u I 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. ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ® 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. D� ,11 ,tee, t:, �.‘,A... OWNER NAME: Everett Church of Christ TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2426 Rockefeller Ave en-v Everett STATE WA ZIP 98204 OWNER PHONE: OWNER EMAIL: Beck@hoepke.net CONTRACTOR NAME: Rex Electric Service Inc. CONTRACTOR ADDRESS: STREET 11112 18th ST NE CITY Lake Stevens STATE WA zip 9825& CONTRACTOR PHONE: 425-422-1744 'CONTRACTOR EMAIL: rriecks@gmail.com • CONTRACTOR LIC.#(REQUIRED): REXELES962N4 CITY OF EVERETT BUSINESS LIC.#(REQ -ED): PRIMARY CONTACT: 0 OWNER [ONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-422-1744 Robin Riecks CONTACT EMAIL: rrieckS@gmail.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# 1-22-19 6 ,e i- Etc101 _ 2- Owner/Authorized Agent Signature Date (Revised 10/30/2018)