607 11TH ST 2021-02-23 - Laserfiche WebLink

• 5-325 2, ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 I(E)everetteps@everettwa gov I ww.everettwa.govipermits PROJECT SITE INFORMATION PROJECT ADDRESS: 607 11th St BUILDING AREA: sx sq ft PROJECT TYPE: [El NEW CONSTRUCTION El ADDITION TENANT IMPROVMENT LI REMODEL BUILDING USE: 0 SFR E TOWNHOUSE El DUPLEX 0 ADU El MULTI-FAMILY-#OF UNITS COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK; 7700 ASSOCIATED BUILDING PERMIT#Of applicable): DESCRIBE SCOPE OF WORK: Install (4) NEW IP cameras next to existing IP cameras for additional video coverage of marina. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? E NO 7 YES-Select Scope: LI Service U Feeder E Circuits-#: E Complete Re-wire LOW VOLTAGE WORK? El NO El YES-It of Devices:4 SELECT SCOPE(REQUIRED): El Data 0 Intercom 7 Thermostat E Audio El Secure Access El Security System El 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. 7 Other(List Ail): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 7 NO El YES--See Below&Pg.2 I 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 7 Pursuant to RCW 1928.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sate,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: Port of Everett TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: EC Company CONTRACTOR ADDRESS: smEET 981 Powell Ave SW crry Renton STATE WA zip 96057 CONTRACTOR PHONE:206-799-9063 CONTRACTOR EMAIL:rich,kibbie@ecpowerslife,com CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: Cl OWNER ECONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:thereby certify that I have reed and examined this application and know the same to be true and correct. All provisions of laws end ordinances governing this * type of work will be completed whether specrhed 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: o 7-11-19 Owner/Authorized Agent Signature Date (Petriseci 0112019) Page I-Application