2405 COLBY AVE 2021-09-22 - Laserfiche WebLink

411 • MN ELECTRICAL PERMIT APPLICATION 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 Z*d PROJECT SITE INFORMATION PROJECT ADDRESS: 2+I$Colby Ave, Everett, WA 98201 BUILDING AREA: 2.435 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 54,500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Renovation of two classrooms and one workroom withing an existing school building. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO 0 YES-Select Scope:❑Service ❑ Feeder 0 Circuits-#:9 ❑Complete Re-wire LOW VOLTAGE WORK? El NO 0 YES-#of Devices:20 SELECT SCOPE(REQUIRED): 0 Data 0 Intercom ❑Thermostat 0 Audio 0 Secure Access ❑Security System 0 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 PER IT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO 0 YES--See Below&Pg.2 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: ONO EYES-See Below&Pg. 3 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 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: Everett Public Schools TENANT BUSINESS NAME(If Commercial): Everett High School VOC Bldg OWNER MAILING ADDRESS: STREET 3900 Broadway city Everett STATE WA ZIP 98201 OWNER PHONE:425-385-4195 OWNER EMAIL:Jennifer Collins,Jcollins@evverettsd.org\ CONTRACTOR NAM TBD viol IV) 0 lit) rJv.4) S 1-e if-U-- e,L_cii v►c l V\(- CONTRACTOR ADDRESS: STREETTBD 't 4 122 �O-T.ri- `i/v cR V y \A/y��` STATE kA)A ZIP 9 -L/J-. CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRE S TE E I, t:I S 4-I C5 CITY OF EVERETT BUSINESS LIC.#(REQUIRE )lk 3(C 2) PRIMARY CONTACT: DOWNER ❑CONTRACTOR EllOTHER(Please Specify) Electrical Engineers CONTACT NAME: CONTACT PHONE:206-859-5380 Mark H u m i sto n CONTACT EMAIL:mark.humiston@hargis.biz 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(he work for which application is made and I comply wit- = tate Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: Z I Z j E Zl DI- 1�3 Owner/Authorized Agent 'm��ature D e (Revised 1/11/2019) Pag�pplication