1019 PACIFIC AVE 2023-04-07 - Laserfiche WebLink

NEI E•CTRICAL PERMIT APPLI• 3200TION EVERETTCITY OF EVERETT PERMIT SERVICES CEDAR STREET,EVERETT,WA 98201 WASHINGTON 425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1019 Pacific Ave BUILDING AREA: N/A sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION C TENANT IMPROVMENT ❑ REMODEL BUILDING USE: L SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 1355 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE s:F WORK: Install an addressable Fire Alarm System relay to release doors controlled by the access control system in the event of Fi; ' Alarm System activation. THIS INSTALLATION 'N' .i..IDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? n NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE �` ',tK? ❑ NO ❑✓ YES-#of Devices: 1 SELECT SCOPE r IJ): ❑ 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 COIF LIANCE IS THIS PERMIT EDUG .JN, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑ YES--See Below& Pg. 2 By check 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 ar '`cation (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 PI: ew. ARE YOU AN OWNER I .2FOt 1,ING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO EYES-See Below& Pg. 3 Pursuant' 'OW ,9.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale, or lease without th, oro; :r electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and See Page 3 signed t!' A'•FIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. 'ORATION OWNER NAME: Pugt :!.Ind Kidney Centel' TENANT BUSINESS NAME(If Commercial): Puget Sound Kidney Center OWNER MAILING ADDPE Lt . STREET 1019 PACIFIC AVE CITY EVERETT STATE WA ZIP 98201 OWNER PHONE:425-; o 5944 (OWNER EMAIL:tobiass@pskc.net CONTRACTOR NAME: ' Jmmercial Alarm &.Detection CONTRACTOR ADDRE' S: STFEEr 17199 BENNETT ROAD CITY Mcunt Vernon STATE WA ZIP 98273 CONTRACTOR PHONE.;360) 8.1533 CONTRACTOR EMAIL:eric@cfirepro.com CONTRACTOR LIC.#(R :Qt,;:_.)):COMMEAI948LO CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 043019 PRIMARY CONTACT: 7, IWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(360)661-2630 g I'1'1 e n CONTACT EMAIL:eric@cfirepro.com AGREEMENT:I hereby cert th.. '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 complete. n 1: ther specified herein or not. 'he granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construe. 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 Contr Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#:I I ( 11/18/2021 E 1 l` Owner/Aut rize� r.zture Date (Revised 1/11/2019) Page 1-Application