1700 13TH ST 2023-04-07 - Laserfiche WebLink

•LECTRICAL PERMIT APFCATION 4ffrr 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 I www.everettwa.gov/permits C TE.. I! RMATIQM !, PROJECT ADDRESS: 1700 13th Street Everett, WA 98201 BUILDING AREA: 2500 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION DI ADDITION I✓ TENANT IMPROVMENT REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX LI ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL ELECTR _ : -CATION I _ ATOR & DEKRiPTIOhreirWORK CONTRACT PRICE OF WORK: $ 1400 ASSOCIATED BUILDING PERMIT#(if applicable): NA DESCRIBE SCOPE OF WORK: Install wiring and devices for 2 new access doors. Job #832431 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:8 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): :.. °' CODECOMPLIANCE', IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO Ai 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 v 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. CoNTA WORNIATION OWNER NAME: Providence Hospital TENANT BUSINESS NAME(If Commercial): Providence Hospital OWNER MAILING ADDRESS: STREET 1700 13th Street CITv Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: " _ ... CONTRACTOR NAME: EC Electric CONTRACTOR ADDRESS: STREET 981 Powell Ave SW Suite 200 cm, Renton STATE WA Zip 98057 CONTRACTOR PHONE:206-242-3010 CONTRACTOR EMAIL:SeattlePermits@ecpowerslife.com CONTRACTOR LIC.#(REQUIRED):ECCOM**148BA CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-799-9063 Rich Kibbie CONTACT EMAIL:Rich.Kibbie@ecpowerslife.com 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#: Rich Kibbie 6/11/19 E I0 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application