1730 MADISON ST 2019-11-06 - Laserfiche WebLink

tLECTRICAL PERMIT APPLit.ATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 730 Madison Street, Everett, WA 98203 BUILDING AREA: 5570 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICA FORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 0- a ed Labor&Matls.(ASSOCIATED BUILDING PERMIT#(if applicable): NA DESCRIBE SCOPE OF WORK: \SW Add 2 Low-Frequency Fire Alarm Notification Devices to the sleeping areas in the 2nd floor apartment. Add a smoke detector in the interior egress stairway for the 2nd floor apartment. Move wire for the Fire Alarm panel to a full sized breaker to allow for lock-on device. Change a 2 yoke receptacle to single yoke. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-#:2 ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#of Devices:3 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio El 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): 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: LINO ❑✓YES-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: Mark Matlock TENANT BUSINESS NAME(If Commercial): Kingdom Hall of Jehovah's Witnesses OWNER MAILING ADDRESS: STREET PO Box 1505 CITY Mukilteo STATE WA ZIP 98275 OWNER PHONE:425-501-9304 OWNER EMAIL:wevt.mmatlock@outlook.com CONTRACTOR NAME: Owner Performed Work- "Contractor"contact Information same as Owner's above. CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):NA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): NA PRIMARY CONTACT: DOWNER ❑CONTRACTOR ZOTHER(Please Specify) Project Coordinator CONTACT NAME: CONTACT PHONE:360-661-2630 Erie Sig m e n CONTACT EMAIL:eric.sigmen@gmail.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#: cgc( y�%�i1� 2019-07-26 E `% ^ ` Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application