10115 HOLLY DR BLDG U OLIN FIELDS APTS 2021-12-17

I•� • • Riam ELECTRICAL PERMIT APPLICATION E�/ R C C 7 CITY OF EVERETT PERMIT SERVICES ■ 3200 CEDAR STREET,EVERETT,WA 98201 ,vas i Nc ion (P)425-257-8810 i FAX 425-257-8857 I(E)everettops@everettwa.gov i www.everettwa.gov/permits PROJECT SITE,IRFORMATIONAANA 4s PROJECT ADDRESS: 10115 Holly Drive Everett, WA 98204 Bldg. U [BUILDING AREA: 50 sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX ❑ADU 0 MULTI-FAMILY-#OF UNITS:16 C}COMMERCIAL CONTRACT PRICE OF WORK:$ 3,582.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install fire alarm control panel and install AES radio within a NEMA- 4 enclosure. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO El YES-Select Scope: ❑Service ❑Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO El YES-#of Devices: 2 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat El Audio El 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; w . e . � IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO ❑YES--See Below&Pg.2 II 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 1 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: ✓❑NO EYES-See Below&Pg. 3W IPursuant 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. OWNER NAME:AMC LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 10115 Holly Drive �y r�1� CITY Everett rett STATE �`V�p�,A ZIP 98204 OWNER PHONE: 425- 341- 0146 DOWNER EMAIL: olinfieldsmaintenance@gmaii.c0m CONTRACTOR NAME: Performance Systems integration, LLC DBA Fire King of Seattle CONTRACTOR ADDRESS: STREET 240 S. Holden St. GT1' Seattle STATE WA zw 98108 CONTRACTOR PHONE:206- 763- 4177 (CONTRACTOR EMAIL: tmoore@firekingofseattle,Com CONTRACTOR LIC,#(REQUIRED PERFOS1831PE 'CITY OF EVERETT BUSINESS LIC.#(REQUUIIRED) Q4 003 PRIMARY CONTACT: DOWNER (CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206- 763- 4177 Tami Moore CONTACT EMAIL: trrtoore@a firekingofseattie.cOrn AGREEMENT:I hereby certify that I have read and examined tfris 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 t comply with the State Contractors Law 18.27 RCW and 296:200 WAC. City of Everett Official Use Only PERMIT 1/: ( + 4 —� E Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application