3608 RUCKER AVE 2019-04-30 - Laserfiche WebLink

E meTRICAL PERMIT APF'LlgiTION CITY OF EVERETT PERMIT SERVICESIIIIIr NitirrW— -. 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 l FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.evereitwa.govipermits r u PROJECT ADDRESS: 3608 Rucker Ave 'BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION El TENANT IMPROVMENT D REMODEL BUILDING USE: E�✓ SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU D MULTI-FAMILY-#OF UNITS: D COMMERCIAL :,. g�.. i<6: , e,. -� "� CONTRACT PRICE OF WORK:$ 750.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Adding 60A and 30A 240V circuits for electric furnace THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO 0 YES-Select Scope: D Service El Feeder 0 Circuits-#:2 0 Complete Re-wire LOW VOLTAGE WORK? Q NO 0 YES-#of Devices: SELECT SCOPE(REQUIRED): El Data 0 Intercom D Thermostat D Audio D Secure Access 0 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. 0 Other(List All): IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: I;":I NO U YES--See Below&Pg.2 ❑ By checking this box,I am stating that I have read and understand all of WAC 298-46B-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 DYES-See Below&Pg.3 Pursuant to RCW 19.2&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. OWNER NAME: Donna Christensen TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3608 Rucker Ave p CITY Everett STA E WA 21P 98201 OWNER PHONE: 360-631-9196 OWNER EMAIL: CONTRACTOR NAME: Home Run Electric LLC CONTRACTOR ADDRESS: STREET21118 66th Ave W CnY Lynnwood STATE WA Zip 98036 CONTRACTOR PHONE:428--489-0791 ]CONTRACTOR EMAIL: gdelivery@homerunelectriclic.com CONTRACTOR LIC.#(REQUIRED):HOMERRE974K2 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):041019 n.'.:a ;vmaY._ e� .....:�-.c c:..twe_3,.nv1\l�iroi�YR. - PRIMARY CONTACT: DOWNER CONTRACTOR DOTHER(Please Specify) CONTACT NAME: # CONTACT PHONE: 425-877-4331 Ken Everett CONTACT EMAIL:keverett@homerunelectricllc.com '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 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 lam authorized by the owner of this property to perform the work for which application is made and I comp with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 6-1'149 11D ' nqO + enr°r + a zed Agent S'!net a Dater -Revised 9 . ( 1/11/2019) Page 1-Application