6920 SEAWAY BLVD 2023-06-23 - Laserfiche WebLink

ttECTRICAL PERMIT APPLIC TION CITY OF EVERETT PERMIT SERVICES 32 00 CEDAR STREET,EVERETT,WA 08201 (P)425-257-8810 I FAX 425-257-8857 (F)everetteps@everetiwa.gov www.everettw,s,govipermits PROJECT SITE INFORMATION PROJECT ADDRESS: 1,63 zO BUILDING AREA: 'II 600 sqit PROJECT TYPE: El NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT .t.Z REMODEL BUILDING USE: ED SFR El TOWNHOUSE El DUPLEX El ADO El MULTI-FAMILY-#OF UNITS: COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK =, CONTRACT PRICE OF WORK:$ 450.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: °Provide and install conduit and cable for (1) comm connection from existing nearby JCI controller to nevi b 2-7 214 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO Ell YES-Select Scope:flService E*,) Feeder E Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? El NO ED YES-#of Devices: ' SELECT SCOPE(REQUIRED): El Data El Intercom El Thermostat Cl Audio El Secure Access El Security System El 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. EDOther(List All):comm connection frorr existing nearby JCI controller to new Bolter. CODE COMPLIANCE . , IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND!OR PERSONAL CARE FACILITIES: E] NO El YES—See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296.466-900,selected the specific reason en 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: b,IJNO LJYES-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. CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET ,,r, Everett STATE OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: EC Electric 981 Powell Ave S, Suite 200 CONTRACTOR ADDRESS: S1 RE ET c, Renton STATE WA 98057 CONTRACTOR PHONE:206-436.6070 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED) EC ECCOM**148BA CITY OF EVERETT BUSINESS LIC.#(REQUIRED);051774 PRIMARY CONTACT: DOWNER NCONTRACTOR ['OTHER(Please Specify) _ CONTACT NAME: CONTACT PHONE:206-5030992 Asher SwIssa CONTACT EMAIL:asharswissa@eopowerslife.com • AGREEMEIVT I hereby certify(hell have read and examined this application and know the same to be true and correct All previsions 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 pa rrnan e of construction. That I am authorized by the owner of this property to perform the work for which application is made and! comply with Mc State Contractors Law 1 .27 RC and 296.200 WAC. City of Everett Official Use Only PERMIT#: Asher Swissa EM1101 ° OwnerlAuthorized Agent Si na r Date (Revised 1/11/2019) Page 1-Application