3201 SMITH AVE BASE FILE 2019-09-24

'Orem* E CTRICAL PERMIT APPLI TION CITY OF EVERETT PERMIT SERVICES 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 Ave Everett, WA 98201 BUILDING AREA: sq ft PROJECT TYPE: LJ NEW CONSTRUCTION I ADDITION ❑ TENANT IMPROVMENT L1 REMODEL BUILDING USE: Li SFR ❑ TOWNHOUSE ❑ DUPLEX ADU 11 MULTI-FAMILY-#OF UNITS: ❑,. COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 8360.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Installing 8 CCTV and 1 Receptacle in Lay over yard for train. Installing 2 Receptacles for power to excisting cameras in parking lot. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? NO ❑,. YES-Select Scope: [ Service ❑ Feeder n Circuits-#:3 ❑ Complete Re-wire LOW VOLTAGE WORK? E. NO [ YES-#of Devices:8 SELECT SCOPE(REQUIRED): ❑ Data E. Intercom ❑ Thermostat ❑ Audio ❑ Secure Access ❑ Security 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. ❑.. Other(List All):CCTV install of cameras and receptacles CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, 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 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 See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial): Sound Transit OWNER MAILING ADDRESS: STREET 401 S Jackson St CITY Seattle STATE WA ziP 98104 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 0'p CONTRACTOR ADDRESS: STREET CIN STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER CONTRACTOR ['OTHER(Please Specify) Sound Transit Employee CONTACT NAME: CONTACT PHONE:425-214-6466 Jeff Ne u h a u s e n CONTACT EMAIL:jeffrey.neuhausen@a soundtransit.org AGREEMENT:l 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#: VAR' E\I O22 'Ow er/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application