3800 RIVERFRONT BLVD 2019-09-24 - Laserfiche WebLink

11/07/2018 22:16 2535723628 ROBBLEE'S TOTAL SEC. PAGE 01/03 ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everettepseeverettwa.gov 1 www.everettwa.gov/permits . OJ. cT'SIYE !NF01�111LA"1ION PROJECT ADDRESS: ®JCjO �� v� 61% o PROJECT TYPE-.❑ NEW CONSTRUCTION A •6 DiTION M NANT IMPROVMENT Cl REMODEL BUILDING USE: raisFR ❑ TOWNHOUSE El •UPL, EX 0 •DU IQ- ILTI-FAMILY-#OF UNITS; Isa,COMMERCIAL BUILDING AREA: 1500 sq ft E ECTRICAI.APPLICATION! INFORMATION CONTRACT PRICE OF WORK: 15000 ASS.- •1 ED B IL 0 G PERMIT#(If applicable): r IS THIS LOW VOLTAGE WORK? U NO 0 YES-#OF DEV CES: _ . i IS THIS A FIRE ALARM PERMIT? �� 0 CIYES-Plansrequi d for review(Bo Electrical and Fire Department inspections are required) DES.CRIPTION.OF WORK A CODE COMPLIANCE • DESCRIPTION OF WORK: GATE OPERTORS FOR NEW HOUSING DEVELPMENT . C- [$0q-cx►9 THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: [DIBy checking this box,I am stating that i have read and understand all of WAC 296-48B-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: 101 Pursuant to ROW 19.28.281,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. . 1 CONTACT-INFORMATION OWNER NAME: POLYGON HOMES TENANT BUSINESS NAME(If Commercial): JR HAYES OWNER MAILING ADDRESS: STREET CIN STATE ZIP OWNER PHONE: OWNER EMAiL: CONTRACTOR NAME: ROBBLEES TOTAL SECURITY INC _ CONTRACTOR ADDRESS: STREET 751 TACOMA AVE SOUTH CITY TACOMA STATE WA ZIP 98402 T CONTRACTOR PHONE: 2536275448 CONTRACTOR EMAIL: JiMTP a@ROBBLEES.COM CONTRACTOR LIC.#(fkEQUIRED): ROBBLTS994JD ICITY OF EVERETT BUSINESS up.#(REQUIRED): 054194 PRIMARY CONTACT: jDWNER 1ONTRACTOR n❑OTHER(Please Specify) • CONTACT NAME: CONTACT PHONE: 2536275448 • JIM PATTERSON CONTACT EMAIL: JIMTP@ROBBLEES.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 authorhed by the owner of this property to perform the work for which application Is made and I comply with the State Contractors Law 18.271 CW and 296.200 WAC. City of Everett Official Use Only PERMIT# Ow r/ utho d gent Signature Data (Revised 10/30/2018)