1615 75TH ST SW SNOCO ELECTIONS CENTER 2022-01-24

mil in SECTRICAL PERMIT APPLSATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1615 75th Street SW Suite 110 BUILDING AREA: 20,000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION I1 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL — ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 12,750.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Provide and install 41 each Category 5e cables for data and 13 each Category 5e cables for cameras. Provide and install 1 each singlemode 4 strand fiber from demarcation pointe to suite 110 TR/MDF. 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:54 SELECT SCOPE(REQUIRED): El 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&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 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: Snohomish County TENANT BUSINESS NAME(If Commercial): Sno Co Elections Center OWNER MAILING ADDRESS: STREET 3000 Rockefeller Ave CITY Everett STATE Wa ZIP 98201 OWNER PHONE:425-388-3472 OWNER EMAIL:garth.fell©snoco.org CONTRACTOR NAME: Milne Electric CONTRACTOR ADDRESS: sTREET14582 172nd Dr. SE Suite #1 CITY Monroe STATE WA ZIP 98272 CONTRACTOR PHONE:206-51 0-6579 CONTRACTOR EMAIL:ralph.autore@milneelectric.com CONTRACTOR LIC.#(REQUIRED): MILNEEI101PN CITY OF EVERETT BUSINESS LIC.#(REQUIRED):031702 PRIMARY CONTACT: P OWNER ❑✓CONTRACTOR UOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-423-6862 Andy McDonald CONTACT EMAIL:Andy.McDonald@milneelectric.com AGREEMENT:I hereby certify 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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the St to Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: Owr><er Aut orii gent Si tune Date (Revised 1/11/2019) Page 1-Application