1620 75TH ST SW ALPINE CLEANING AND RESTORATION 2023-05-22

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I(E)PermitServices@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I �.� BUILDING AREA: y"e ! sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑✓ ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$2300 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: ADDING AN AES RADIO FOR FIRE ALARM COMMUNICATION ADDING AN AES RADIO FOR FIRE ALARM COMMUNICATION THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO OYES-Select Scope:❑Service ❑Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? D NO EYES-#of Devices:1 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 LI 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. ❑ 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:KEVIN KACZKA TENANT BUSINESS NAME(If Commercial):ALPINE CLEANING OWNER MAILING ADDRESS: STREET 1 620 75TH ST SW c,n, EVERETT STATE WA z,,98203 OWNER PHONE: L/,,,2 3 , ` 735 7 OWNER EMAIL: CONTRACTOR NAME:CASCADE ALARM LLC CONTRACTOR ADDRESS: STREET20452 84TH AVE S c,,,, KENT STATE WA Z11P98032 CONTRACTOR PHONE:2O6-767-5800 CONTRACTOR EMAIL:CSMITH@CASCADEALARM.COM CONTRACTOR LIC.#(REQUIRED):CASCAAL963JT CITY OF EVERETT BUSINESS LIC.#(REQUIRED):040997 PRIMARY CONTACT: DOWNER ❑r CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-767-5800X 109 Cie,/ ;�,.,,, t CONTACT EMAIL:CSMITH@CASCADEALARM.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#: )/( (7(z/ g ,/p 2 Owner/Authorized Agent Signature Date (Revised 4/5/2022) Page 1-Application