1424 ROCKEFELLER AVE 2019-07-24 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govlpermits -- PROJECT ADDRESS: 1424 ROCKEFELLER BUILDING AREA: l LA l) sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS:_7______ 7 COMMERCIAL ELECTRICAL APP AW TION;INFORMAX1QN _DISCRIPTION.O YII C; - CONTRACT PRICE OF WORK:$ 6000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADDITION TO PERMIT#EW1901-001 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑NO 0 YES-Select Scope: ❑ Service ❑ Feeder ❑Circuits-#: 0 Complete Re-wire LOW VOLTAGE WORK? ❑NO 7YESs.#-offs: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom El Thermostat ❑Audio ❑ Secure Accessecurlty 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. El Other(List All) yryy IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: k NO 171 YES—See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 296-46B-:'0,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. t--� ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: 10 DYES-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. OWNER NAME: REGINA CHACON TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1424 ROCKEFELLEER cin EVERETT STATE WA zlP 98201 OWNER PHONE: 206-370-0811 OWNER EMAIL: REGINACHACON@YAHOO.COM CONTRACTOR NAME: PARKER BROS ELECTRIC CONTRACTOR ADDRESS: STREET 13630 54TH DR NE CITY MARYSVILLE STATE WA zi 98271 CONTRACTOR PHONE:425-239-6319 CONTRACTOR EMAIL:GARY@PARKERBROSELECTRIC.COM CONTRACTO•R LI•C.#(RE•=QUIRED•): PARKEBE845NT CITY OF EVERETT BUSINESS LIC.#(REQUIRED):83]9HMC91 ,_,__ OFFICE _ . _ _ . .. PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ✓❑OTHER(Please Specify) ADMIN 5-(CIACC 't _ CONTACT NAME:NATAL I E CONTACT PHONE:360-572-0108 CONTACT EMAIL: admin@parkerbroselectric.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 1 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#: ./i(1 5/06/2019 EYE 0 _J C, Owner/Authorized Agen Signature Date (Revised 1/11/2019) Page 1-Application