2416 COLBY AVE 2022-02-28 - Laserfiche WebLink

1• ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 i FAX425-257-8857 � (E) everetteps@everettwa.gov i www.everettwa.gov/permits PIRQJECT SITE INFOR A7"111ON", PROJECT ADDRESS: 2416 Colby Ave Everett WA 98203 BUILDING AREA: 10000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑✓ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ✓❑ COMMERCIAL ELECTRICAL APPLICATIONINFORMATION & DESCRIPTION OF; ORK CONTRACT PRICE OF WORK: $ 35000 1ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: Installation of telecommunications cabling THIS INSTALLATION INCLUDES THE FOLL ING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO Xy.ES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑Complete Re -wire LOW VOLTAGE WORK? ❑ NO YES- # of Devices: "o devices, just cabling 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' COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: NO ✓ YES -- See Below 8 Pg. 2 By checking this box, I am stating that I have read and understand all of WAC 296-46113-900, selected the specific reason on page 2 Fv] of this application (see next page), AND Plan Review is NOT required because 1 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: ✓ NO OYES -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 1 have completed and See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONrAr PT, I1RMATION !OWNER NAME: Everett School District TENANT BUSINESS NAME (If Commercial): Everett High School OWNER MAILING ADDRESS: sTReer 3900 Broadway CITY Evertt STATE WA zi, 98201 OWNER PHONE:425-385-4000 OWNER EMAIL: CONTRACTOR NAME: Skyline Communications CONTRACTOR ADDRESS: ITIEET12002 Beverly Park Rd CITY Everett SrArE WA Z,p 98204 CONTRACTOR PHONE:425-355-1593 CONTRACTOR EMAIL:tracy.berry@skylinecommunications.net CONTRACTOR LIC. #(REQUIRED),SKYLICl933Q7 CITY OF EVERETT BUSINESS LIC. #(REQUIRED): I t (' PRIMARY CONTACT: DOWNER ❑✓ CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: Chris Tracy CONTACT PHONE:425_583-7761 CONTACT EMAIL:Chris.Tracy@skylineemmunications.net 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 WAG City of Everett Official Use Only PERMIT # 7 Qwn 1A_ horized t $igriature Date ('Revised 1/11fif119) Page 1-Application