1800 41ST ST 2019-09-10 - Laserfiche WebLink

ELECTRICAL PtiRMIT & 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 47-7- PRO-44dt SITE INFORMATION PROJECT ADDRESS: 1800 41st Street Everett WA 98203 PROJECT TYPE: ENEW CONSTRUCTION ❑❑ADDITION 1:71TENANT IMPROVMENT a REMODEL BUILDING USE: 1SFR 0 TOWNHOUSE tilDUPLEXDU 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL BUILDING AREA: sq ft ..,. , ....? -:: ;ELIC e, . b APPUCATIO.N ORMA1ION , . CONTRACT PRICE OF WORK:$ 3756.00 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? Sid NO 0 YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? [ NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) IRIS '''''''';';'7;,'.Rit&,CODE COMPLIANCE 1 DESCRIPTION OF WORK: Demo (15) existing HID lamps and install (15) LED Lamps THIS SECTION APPLIES TO ALL EDUCATION, INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 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. 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. we'''''''''-''''' COiii,�AC' 1NF©RIYI TION f�,�c,�e-."! a .. ... .r OWNER NAME: 1800 41St LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1800 41st St ciT- Everett STATE WA ZIP 98201-5072 OWNER PHONE: 425-259-3735 OWNER EMAIL: Brian.baker@am.jll.com CONTRACTOR NAME: Titan Electric Inc CONTRACTOR ADDRESS: STREET 12828 Northup Way Suite 205 CITY Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE: 206-633-2811 CONTRACTOR EMAIL: permits@titanelectric.net CONTRACTOR LIC.#(REQUIRED): TITANE1963OB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051191 PRIMARY CONTACT: [OWNER Pi3ONTRACTOR COTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206.633.2811 Linda Anderson CONTACT EMAIL: permits@titanelectric.net 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# ......,:.:,, Ityssigned-by aL@a aAndlesoE \g - 0(9r 0=Ttan Electric Linda AndersonanylncCNLdaAndersonet, per2018.11.01 13:49:34-07'00' Owner/Authorized Agent Signature Date (Revised 10/30/2018) Page 1 of 3