524 75TH ST SE 2019-11-15 - Laserfiche WebLink

ELECTRICARERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES "IIIIPAA 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 r (E)everetteps@everettwa.gov I www.everettwa.gov/permits _ . • � q, ■ �a� t ,e,.:. ).': , '.":•, :- a a PROJECT ADDRESS:524 75TH ST SE PROJECT TYPE: 0NEW CONSTRUCTION ❑ADDITION * ENANT IMPROVMENT REMODEL BUILDING USE: ❑ .FR 0 OWNHOUSE I IUPLEX 0 •DU a ULTI-FAMILY-#OF UNITS: 0 OMMERCIAL BUILDING AREA: sq ft CONTRACT PRICE OF WORK; $980.00 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? 2100 _❑ YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ® O ❑'YES-plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK: PROVIDE&INSTALL CONDUIT,WIRE,J-BOXES AND EGRESS(BUG EYE TYPE)LIGHTS IN(2)LOCATIONS THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: IIBy checking this box, I am stating(hat 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. ATTENTION OWNERS: THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: 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. li , OWNER NAME: TENANT BUSINESS NAME(If Commercil): TERRACE AT BEVERLY LAKE -..„___—_------ OWNER MAILING ADDRESS: sTREET cnv STATE IJP OWNER PHONE; OWNER EMAIL: .._ ... ... . � ._.. ._ ., , ,4„_ „e�•C.. Win.. .,. CONTRACTOR NAME: SEAHURST ELECTRIC INC CONTRACTOR ADDRESS: STREET 2915 CHESTNUT ST crTv EVERETT STATE INA lip 98201 CONTRACTOR PHONE:425-258-1882 1CONTRACTOR EMAIL: reception@seahurst.com CONTRACTOR LIC.#(REQUIRED):SEAHUE10990N JCTTY OF EVERETT BUSINESS LIC.#(REOUIRED): 18763 PRIMARY CONTACT; ❑ •WNER EONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-258-1882 -KIM SMITH CONTACT EMAIL: reception@seahurst.Com AGREEMENT:t 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 Officio!Use Only PERMIT# 104( e 7/F ,/� �� 0 en/ utharizedent Signature Dae (Revised 10/30/2098) Page 1 of 3