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1111 •how <br /> Lim ELECTRICALPERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASNtNaTON (P)425-257.8810 I FAX 425-267-8857 1(E)everetteps( everettwa.gov www.everettwa,gov/permits <br /> 1P!ii� <br /> PROJECT ADDRESS: 8823 Holly Drive Bldg R BUILDING AREA: sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION C7I TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: El SFR El TOWNHOUSE ❑DUPLEX El ADO El MULTI-FAMILY-#OF UNITS: ®COMMERCIAL <br /> ... .. :`i 4it' ' ILC i. ApL;CA .ON INF�.ORM,A"flhii�.< ;R> CRIPTitON# �f'... . .... <br /> CONTRACT PRICE OF WORK:$ 900 1ASSOCLATED BUILDING PERMIT#(If applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> Replace the existing &falling conventional fire alarm control panel with new conventional FACP In and <br /> for building R. Applying for "Panel Swap Permit" <br /> se,0616, ,v (-,,e ,-,e-in,1743-bt- P9.2007-04% e -/4416) <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑NO 0 YES-Select Scope:El Service El Feeder ®Circuits-4:1 El Complete Re-wire <br /> LOW VOLTAGE WORK? El NO ®YES-#of Devices:1 <br /> SELECT SCOPE(REQUIRED): ❑Data ❑intercom El Thermostat El Audio ❑Secure Access El Security System <br /> (�Fire Alarm-installations under this permit only Include electrical wiring rough-in of the system.An additional <br /> Fire Alarm Permit Is required for review of device location and installation approval. <br /> El Other(Ust <br /> • tG .DEC.OMPiL; N 1; <br /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO U YES See Below&Pg.2 <br /> ❑ By checking this box,I am stating that I have read end understand all of WAC 296.46E-900,selected the specific reason on page 2 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review, �—I ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:LNO OYES-See Below&Pg.3 <br /> EE.rPursuant to RCW 19.28.281,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> . <br /> without the proper electrical IIcenskig and certification,or exemption.By checking this box,I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this llcensing/certilication requirement. <br /> CONTACT;INFORMATION <br /> OWNER NAME: Micheal Carter TENANT BUSINESS NAME(If Commercial): Sunset Park South(HOA) <br /> OWNER MAILING ADDRESS: STREET <br /> CRY STATE ZM' <br /> OWNER PHONE: 425-399-2437/425-29t3-9261 �oWNER EMAIL:umpire24@juno.com <br /> CONTRACTOR NAME: Commercial Alarm&Detection, Inc, <br /> CONTRACTOR ADDRESS: srrwEr 17199 Bennett Rd. <br /> cm, Mt. Vernon STATE WA zip 98273 <br /> CONTRACTOR PHONE:509-868-8485 CONTRACTOR EMAIL:ron@cfirepro.com <br /> CONTRACTOR LIC.#tREQUIRED):COMMEAI948LO CITY OF EVERETT BUSINESS M.#(REQUIRED):043019 <br /> PRIMARY CONTACT: DOWNER ®CONTRACTOR (]OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:380-848-1533 x111 <br /> Krista Swanson CONTACT EMAIL:krlsta►tcfirepro.com <br /> AGREEME r r y cart at!have examined this e n and know the same o true and correct. All provf s o ws and ordinances gyve g t <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to veleta or cancel the provisions of any other stale or <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 29&200 WAC, City of Everett Official Use Only <br /> PERMIT#: <br /> .114,/ 7,47(eiY E 0 I 051 <br /> Owner/Authorr d Agent Sign ure Date f (Revised f/f If2019) Page 1-Application <br />