12815 19TH AVE SE 2020-01-21 - Laserfiche WebLink

NMI __ECTRICAL PERMIT APPLYLATION EVERETT CITY OF EVERETT PERMIT SERVICES l S� I vt✓ 1 a c 3200 CEDAR STREET,EVERETT,WA 98201 I J WASHINGTON (P)425-257-8810 I FAX 425-257-8857 www.everettwa.gov/permits everetteps@everettwa.gov I ww.everettwa.gov/permits 161. y /1,,ROJECT SITE INFORMATION PROJECT ADDRESS: \ l(2)-W) BUILDING AREA: V\ . sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: 7 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 8,000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add devices to an exsisting access control system. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? .® NO El YES-Select Scope:❑ Service ❑ Feeder E Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? El NO ❑✓ YES-#of Devices:15 SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat El 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): 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: ENO 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: everett public schools TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3900 broadway C,Ty everett STATE wa ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Steele electric CONTRACTOR ADDRESS: STREET4722 bayview lane CITY Everett STATE YV��/ A ZIP 98203 CONTRACTOR PHONE:425-876-7488 CONTRACTOR EMAIL:travis@steeleec.com CONTRACTOR LIC.#(REQUIRED):STEELEI841CS CITY OF EVERETT BUSINESS LIC.#(REQUIRED): *t ),(Qb ?7 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4.25-87 f-7488 travis steele CONTACT EMAIL:travis@asteeleec.corn 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 focal 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#: /AI _t -, is 9 E \,0 )'1" IoQit Owner/" orized Agent Signe Date (Revised 1/11/2019) Page 1-Application