5615 EVERGREEN WAY HERITAGE BANK 2021-11-02

ELECTRICAL PRMIT & FIRE ALARM PETIT APPLICATION 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 I www.everettwa.gov/permits F PROJECT ADDRESS:5615 Evergreen Way, Everett,WA 98203 PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION ©TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ©COMMERCIAL BUILDING AREA: sq ft CONTRACT PRICE OF WORK:$500 ASSOCIATED BUILDING PERMIT#(if applicable):M1901-088 IS THIS LOW VOLTAGE WORK? El NO ©YES-#OF DEVICES:1 IS THIS A FIRE ALARM PERMIT? ©NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK: Install (1)Low Volt Thermostats IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ©NO ❑YES--See Below&Pg.2 l 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:©NO DYES-See Below&Pg.3 111 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. alar�� gt N..�k OWNER NAME: Heritage Bank TENANT BUSINESS NAME(If Commercial): Heritage Bank-Evergreen OWNER MAILING ADDRESS: STREET PO BOX 1578 clTv Olympia STATE WA ZIP 98507 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:D.K. Systems, Inc. CONTRACTOR ADDRESS: STREET PO Box 886/962 S. Spruce Street crry Burlington STATE WA ZIP 98233 CONTRACTOR PHONE:360-755-1555 CONTRACTOR EMAIL:dulce@dksystemsinc.com LA:30N44.„... CONTRACTOR LIC.#(REQUIRED):DKSYSI*982L1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ©CONTRACTOR D OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-755-1555 Dulce Herrera CONTACT EMAIL:dulce@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 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# LI j.Digitally signed by Dulce Herrera e ko\O Dulce Herrera Date:2019.02.2711:32:26-08'00' 12-27-2018 Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application