2802 HOYT AVE LIBRARY PLACE SOUTH STACK 2021-02-22

ELECTRICAL PERMIT AP LICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2802 HOYT AVE, EVERETT, WA 98201 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ADDITION TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓COMMERCIAL •- ELECTRICAL"APPLICATION INFORMATION &DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 852 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: REPLACE EXISTING FIRE ALARM CONTROL PANEL THIS INSTALLATION INCLUDES THE FOI,th ING COPE: (SE LL THAT APPLY) LINE VOLTAGE WORK? ❑ NO /—YES-Se ct Scope: ig Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ✓YES-# f Devices: 1 SELECT SCOPE(REQUIRED): ❑ Data ❑ I room ❑Th- u` T.T:'at ❑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-901,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 ✓ IO EYES-See Below&Pg. 3 Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on .ullaings 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. I CONTACTANFORMAT4 1 OWNER NAME: ELKS LODGE B POE 479 TENANT BUSINESS NAME(If Commercial): LIBRARY PLACE SOUTH OWNER MAILING ADDRESS: STREET STACK CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: SMITH FIRE SYSTEMS CONTRACTOR ADDRESS: STREET 1106 54TH AVE EAST CITY TACOMA STATE WA ZIP 98424 CONTRACTOR PHONE: 253-248-2000 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 23577 PRIMARY CONTACT: ❑OWNER CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-248-2364 SARAH BUCHER CONTACT EMAIL: SBUCHER@SMITHFIRE.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 Sarah Digitally signed by Sarah PERMIT#: Br r 20 C ` ` 2 Bucher 13:59: 7 0. 00' C J \ ,vl 13:59:47-0T00' Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application