840 N BROADWAY 2022-01-20 - Laserfiche WebLink

ECTRICAL PERMIT APPL•NTION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINOTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT.. .. AI"ION PROJECT ADDRESS: 840 North Broadway BUILDING AREA: 107000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: El SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION;8 DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 15000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Replacing fire alarm system that services both buildings A&B. 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:219 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): E %1 IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: Eg NO 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: ONO 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: GPT Properties Trust TENANT BUSINESS NAME(If Commercial): 840 North Broadway OWNER MAILING ADDRESS: STREET 255 Washington St ,,T,, Newton STATE MA ZIP 02458 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Western States Fire Protection CONTRACTOR ADDRESS: STREET14690 NE 95th ST #101 CITY Redmond STATE WA Zip 98052 CONTRACTOR PHONE:425-881-01 00 CONTRACTOR EMAIL:seth.Zehnder@wsfp.US CONTRACTOR LIC.#(REQUIRED):WESTESF906P1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):20553 PRIMARY CONTACT: DOWNER ['CONTRACTOR ❑OTHER(Please Specify) Western States Flre Protection CONTACT NAME: CONTACT PHONE:425-478-9709 Seth Ze h n d e r 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#: 6/28/2019 E D (r 1 9) Owner/ uthorized Agent Signature Date (Revised 1/11/2019) Page 1-Application