1424 ROCKEFELLER AVE 2019-07-24 - Laserfiche WebLink

ELECTRICAL ØRMIT & FIRE ALARM PIT APPLICATION CITY OF EVERETT PERMIT SERVICES �--� 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits 14).4 PROJECT SITE INFORMATION PROJECT ADDRESS:1242 Rockefeller Ave PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: Q SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION.INFORMATION • CONTRACT PRICE OF WORK:$ 2000 ASSOCIATED BUILDING PERMIT#Of applicable): IS THIS LOW VOLTAGE WORK? ❑✓ NO El YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? 0 NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK& CODE COMPLIANCE DESCRIPTION OF WORK: Install three dedicated circuits IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO ❑YES--See Below&Pg.2 ❑ By checking this box,I am stating that I have read and understand all of WAC 296468-900,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 OYES-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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Regina Chacon TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1242 Rockefeller Ave orry Everett STATE WA ZIP 98201 OWNER PHONE: 206-370-0811 OWNER EMAIL: reginachacon@yahoo.com CONTRACTOR NAME: Parker Bros Electric CONTRACTOR ADDRESS: STREET 13630 54th Dr. NE cnv Marysville STATE WA zip 98271 CONTRACTOR PHONE: 425-239-6319 CONTRACTOR EMAIL: gary@parkerbroselectric.com \Q t 1/7 Dq CONTRACTOR LIC.#(REQUIRED): PARKEBE845NT CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 88191 91010918 PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR E]OTHER(Please Specify) Admin CONTACT NAME: Natalie P CONTACT PHONE: 360-572-0108 .larderbrOSe lef�}Y'I L®ipnu Cbpi CONTACT EMAIL:admin@parkerbroselectric.com J AGREEMENT:t hereby certify that!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# 1/4/2019 co Owner/Authorized gen Signature Date (Revised 11/5/2018) Page 1-Application