7100 EVERGREEN WAY 2019-09-05 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT 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 L PROJECT ADDRESS: 7100 EVERGREEN WAY, SUITE A PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION El TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: ®COMMERCIAL BUILDING AREA: sq ft - ioN AT N ° :.mom CONTRACT PRICE OF WORK:$500-00 ASSOCIATED BUILDING PERMIT#(if applicable):--, IS THIS LOW VOLTAGE WORK? El NO ❑YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? El NO ❑ YES-Plans required for review(Both Electrical and Fire Department/nspections are required) a DE DESCRIPTION OF WORK: DISCONNECT& RECONNECT RTU I�►'l i I t 01'6 IS THIS PERMIT EDUCATION,INSITUTIONAL,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: NO Elves-See Below&Pg.3 ElPursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or tease 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 licensingicertifiication requirement.44- CIWACT 10FOR t .ION • x; OWNER NAME: TENANT BUSINESS NAME(If Commercial):WINDERMERE PROPERTY MNGT OWNER MAILING ADDRESS: STREET cur STATE ZIP OWNER PHONE: OWNER EMAIL; CONTRACTOR NAME: SEAHURST ELECTRIC INC. CONTRACTOR ADDRESS: STREET 2915 CHESTNUT ST CITYEVERETT STATE WA zP 98201 CONTRACTOR PHONE: !CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): SEAHUEI099QN CITY OF EVERETT BUSINESS LIC.#(REouIRED): 18763 PRIMARY CONTACT: ❑OWNER ®CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-258-1882 KIM SMITH CONTACT EMAIL: reception@seahurst.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 o _m6_„ alp (03 n Authorize gent Signature PERMIT# Date (Revised 11/5/2018) Page 1-Application