3200 CEDAR ST BLDG 1 2021-11-15 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits 416-77. PROJECT SITE INFORMATION PROJECT ADDRESS: 3200 Cedar St Annex 2 BUILDING AREA: 200 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL 'ICATION INFORWION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 1000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Replacing non listed dialer with a fire alarm panel for sprinkler monitoring. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑ 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 CO NC �; 1 IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ErNO 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: ENO 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: City Of Everett TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3200 Cedar St C,N Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Western States Fire Protection CONTRACTOR ADDRESS: STREET 14690 NE 95th St#101 cm( Redmond STATE WA ZAP 98052 CONTRACTOR PHONE:425-881-0100 CONTRACTOR EMAIL:seth.zehnder@wsfp.us CONTRACTOR LIC.#(REQUIRED):WESTESF906P1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ['CONTRACTOR ['OTHER(Please Specify) 020553 CONTACT NAME: CONTACT PHONE:425-478-9709 Seth Zehnder CONTACT EMAIL:seth.zehnder@wsfp.us 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 PERMIT#: r E9-0(1- IL\ ,• 7/2/2020 Ow r/A thorized Agent Signature Date (Revised 1/11/2019) Page 1-Application