840 N BROADWAY 2022-01-11 - Laserfiche WebLink

S ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)evvrerettepis@everettwa.gov 1 wvw.everettwa.govlpemrits ;;^ '� e �,. `fiie�'-,.�3A '�'� },k„��E�ROY� EgL�NFORM ATIO ....c`Cx{I `a.�,�) -K.<.e I s r } - ry-_. .� .._c .,.y.a...;.- .,zs..� ..,. .Ln.6.-,-.,^„F.. �, t . � - J;...._ .� J_ t��}� �-. ...C. ....v.f.� � le r .. PROJECT ADDRESS: 840 N Broadway BUILDING AREA: 4200 sq ft PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: IN COMMERCIAL CONTRACT PRiCE OF WORK:$ ASSOCIATED BUILDING PERMIT#(if applicable): . DESCRIBE SCOPE OF WORK:Add lobby smoke detection to all landings for four elevators, 14 total. Add machine room smoke detector to four elevator machine rooms, 4 total. Add Shunt heats to four machine rooms, 4 total. Add shunt power monitor modules to four machine rooms, 4 total. Add PRI ALT and HAT relays to four machine rooms, 3ea x 4 MRs, 12 total. Add heat detection to four pits THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ® NO ❑YES-Select Scope:❑ Service ❑ Feeder ❑ CIrcults-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO ®YES-#of Devices: 42 SELECT SCOPE(REQUIRED): El Data ❑ Intercom ❑Thermostat ❑Audio Cl Secure Access El 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): • 14� �'�l�,yr�,._zSx IS THiS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: IKI NO Li YES--See Below&Pg.2 By checking this box,I am stating that I have read and understand all of WAC 298-46B-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:®NO 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. T ^ar r z 'h' f T ; atAali � i• cW e' �i 'MAI 41 IKSZEU; °`WSO ,rntM OWNER NAME: RMR Group TENANT BUSINESS NAME(If Commercial): DSHS OWNER MAILING ADDRESS: STREET 401 Elliott Ave West, #150 cry Seattle STATE WA zip 98119 OWNER PHONE: 206-216-4946 OWNER EMAIL: Allen Shields ashields@rmrgroup.com CONTRACTOR NAME: 16d I I C CONTRACTOR ADDRESS: STREET PO Box 804 crry Vashon STATE WA • ZIP 98070 CONTRACTOR PHONE: 253-225-6025 CONTRACTOR EMAIL: evan@16dlIc.com CONTRACTOR LiC.#(REQUIRED): 16dlII*882JT CITY OF EVERETT BUSINESS LIC,#(REQUIRED): 62057 PRIMARY CONTACT: DOWNER ®CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-225-6025 Evan Robbins CONTACT EMAIL: evan ae16dllc.com AGREEMENT.'!hereby certl&that!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!am authorized by the owner of this property to perform the work for which application Is made and 1 comply with the State Contractors Law 18.27 RCW end 298.200 WAC. City of Everett Official Use Only PERMIT#: Digitally signed by Evan Robbins ///]]�� Evan Robbins DM C=US,EEvan@i6dllawm,0=16d Hs, E.).Zo —O2- I OU=Engineering,CN=Evan Robbins C I Date:2020.05.06 10:30:11-07'00' Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application