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• <br /> ELECTRICAL PERMIT APPLICATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINOTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ;Tell 4441 r 1 M ,*11.I IS/:715 re/h IP- <br /> PROJECT ADDRESS: 2732 Grand Ave, Everett, WA 98201 BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL <br /> LECTR(CALAPPLICATION INFORMATION &'DESCRIPTION OF_WORKA tt,-"' MI*W.. <br /> CONTRACT PRICE OF WORK:$ 1872.75 (ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> The scope of this project is to replace (1) existing smoke detector and to add <br /> (1) new conventional zone expander module to supervise two dry risers. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ✓❑ NO E YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ✓❑YES-#of Devices: 2 <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑ Audio ❑ Secure Access ❑ Security System <br /> ✓❑ Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> CODE;COMPLIANCE S O eg: M ro „o <br /> A1o._, .. . <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑ YES--See Below&Pg.2 <br /> 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO EYES-See Below&Pg.3 <br /> Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> ONTACT.INFORMATIO . <br /> OWNER NAME: Herald Holdings LLC TENANT BUSINESS NAME(If Commercial): Herald Site 1 <br /> OWNER MAILING ADDRESS: STREET 2707 Colby Ave, Suite 1200 <br /> c,Ty Everett STATE WA ZIP 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: SMITH FIRE SYSTEMS <br /> CONTRACTOR ADDRESS: STREET 1106 54TH AVE EAST <br /> cnv TACOMA STATE WA ZIP 98424 <br /> CONTRACTOR PHONE: 253-924-1880 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): SMITHFS861RS CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 23577 <br /> PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-248-2051 <br /> Rachel Bennett CONTACT EMAIL:rbennett©SMITHFIRE.COM <br /> AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#:ER <br /> Rachel Bennett 051721 ` 2_I©e - <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application + <br />