3319 COLBY AVE 2022-01-11 - Laserfiche WebLink

E EgICTRICAL PERMIT APPLIderION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 wasH NGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps©everettwa.gov I www.everettwa.gov/permits FrEiNFORMION PROJECT ADDRESS: 3319 Colby Ave BUILDING AREA: sq ft PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT 0 REMODEL BUILDING USE: El SFR 0 TOWNHOUSE ID DUPLEX El ADU 0 MULTI-FAMILY-#OF UNITS: CI COMMERCIAL '4* CONTRACT PRICE OF WORK:$ 4298 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: installation of CCTV and security systems in office areas THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) UNE VOLTAGE WORK? El NO 0 YES-Select Scope:El Service El Feeder El Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO 0 YES-#of Devices:6 SELECT SCOPE(REQUIRED): 0 Data 0 intercom 0 Thermostat El Audio D Secure Access 0 Security System 0 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. 0 Other(List All): 4iFintifikiaalin,75.Liii4:4.1„14FHVI0,000.i...7 iiiIMO.EaRiti,41 :777t1Itiligigitiili?,tilATAV4.-J, IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: in NO LI 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 ri 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 licensingfcertification requirement. nataNtigigtiVen:..20(1.00*-01110;~rtOttain'Sg,.;,4-nt:c,,,APOSFrarniAritAK OWNER NAME: Skotdal Real Estate TENANT BUSINESS NAME(If Commercial):Glacier Vista OWNER MAILING ADDRESS: STREET 2707 Colby Ave Suite 1200 crry. Everett STATE WA ztp 98201 OWNER PHONE:425-22-6400 OWNER EmAIL:craig.skotdal@skotdal.corn CONTRACTOR NAME: Froula Alarm Systems, Inc CONTRACTOR ADDRESS: sTREET861 industry Dr CITY Tukwila STATE WA zlp 98188 CONTRACTOR PHONE:206-575-1962 CONTRACTOR EMAIL:alexis@froulaalarms.com CONTRACTOR UC.#(REQUIRED): CITY OF EVERETT BUSINESS Lie.#(REiQuiRED)t VJ(,J2tLkL PRIMARY CONTACT: DOWNER DCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-676-1962 A I ex Is CONTACT EMAIL:alexis@froulaalarrns.com AGREEMENT:I hereby cettify that I have read and examined(his application and know the seine to he 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 ROW and 296.200 WAC. City of Everett Official Use Only PERMIT If: YA,A, 31 Owner/Authorized Agent Signature Oats! (Revised 1/11/2019) Page 1-Application