840 N BROADWAY A 2020-08-27 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov E www.everettwa.gov/permits PROMICT SETE EMPORINATION PROJECT ADDRESS:840 N Broadway Bldg A PROJECT TYPE: 0 NEW CONSTRUCTION O ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: El SFR ❑TOWNHOUSE El DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL BUILDING AREA: sq ft25000 11111.11CTRICAL APPLICATIONA, CONTRACT PRICE OF WORK:$ 12,500 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? ❑NO ❑✓ YES-#OF DEVICES:65 IS THIS A FIRE ALARM PERMIT? El NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK&CODE . COMPLIANCE ., DESCRIPTION OF WORK: Access Control&Security IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ® NO ❑YES--See Below&Pg.2 (l 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 1 I 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ONO EYES-See Below&Pg.3 f{ Pursuant to RCW 19.28.261,propertyowners 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. IVINITACT DIFORMATION OWNER NAME:DSHS Everett TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET840 N Broadway A cny Everett STATE WA aP 98208 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:SeaCOm Cabling Inc CONTRACTOR ADDRESS: STREET3014 Hoyt Ave err),Everett STATE WAT_IP 98201 CONTRACTOR PHONE:425-317-8259 _CONTRACTOR EMAIL:RLOWERY@CALLSEACOM.COM CONTRACTOR LIC.#(REQUIRED):SEACOCI944DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 053655 PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-530-7363 Randy Lowery CONTACT EMAIL:rlowery@callseacom.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 taw 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# r ! : 7 (1 Q. t Ole - C S Owher/Authorizednature Date (Revised 11/5/2018) Page 1-Application