2405 COLBY AVE 2022-11-16 - Laserfiche WebLink

•ECTRICAL PERMIT APPLIPATION 0477 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2416 Colby Ave BUILDING AREA: 15000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ✓❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 33,175.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add of Clock/Speakers and Classroom A/V in new rooms 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:65 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): 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 DYES-See Below&Pg. 3 Pursuant to ROW 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: Everett SD TENANT BUSINESS NAME(If Commercial): Everett High School OWNER MAILING ADDRESS: STREET 2400 Colby Ave JOLLc-'l'1(;v -1 ?jar CITY Everett STATE WA ZIP 98201 OWNER PHONE: (425) 385-4400 OWNER EMAIL:vvebmaster@everettsd.org CONTRACTOR NAME: Dimensional Communications CONTRACTOR ADDRESS: STREET 1220 Anderson Road CITY Mount Vernon STATE WA ZIP 98274 CONTRACTOR PHONE:360-424-6164 CONTRACTOR EMAIL:colbyp@dimensional.net CONTRACTOR LIC.#(REQUIRED):DIMENC1110QA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 030351 PRIMARY CONTACT: [i]OWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-424-6164 Colby Plagge CONTACT EMAIL:colbyp@dimensional.net 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#: I (n / 10/22/2019 ` Owner/Auto. • F : Agent Sig a Date (Revised 1/11/2019) Page 1-Application