3201 SMITH AVE BASE FILE 2019-09-24

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 'jP7a 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:3201 Smith Avenue, 98201 Everett Station PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 306,09ASSOCIATED BUILDING PERMIT#(if applicable):Mechanical Perr tApprcatinSubm,ttedsa,,eday. IS THIS LOW VOLTAGE WORK? CINO ✓❑ YES-#OF DEVICES:(1) Boiler IS THIS A FIRE ALARM PERMIT? 0 NO El YES- Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Disconnect and Connect (1) "Like for Like" Boiler IS THIS PERMIT EDUCATION, INSITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO ❑YES--See Below&Pg. 2 n1 1 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: ONO EYES-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: City of Everett- Everett Station TENANT BUSINESS NAME(If Commercial): City of Everett- Everett Station OWNER MAILING ADDRESS: STREET3200 Cedar Street cin, Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:D.K. Systems, Inc. CONTRACTOR ADDRESS: STREET PO Box 886/962 S. Spruce Street CITY Burlington STATE WA ZIP 98233 CONTRACTOR PHONE:360-755-1555 CONTRACTOR EMAIL:darron@dksystemsinc.com CONTRACTOR LIC.#(REQUIRED):DKSYSI"982L1 ,CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 049744 PRIMARY CONTACT: ❑OWNER IZ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-755-1555 Da rro n Drake CONTACT EMAIL:darron@dksystemsinc.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 PERMIT# Owner/Authorized Agent Signature Date (Revised 11/5/2018) (Page 1-Application