6920 SEAWAY BLVD 2023-06-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION TION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 011*-17 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits " ' PROJECT SITE INFORMATION tet �., ,. la ,^ ! PROJECT ADDRESS: 6920 Seaway Blvd BUILDING AREA: 2300 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL 1 i ELECTRICAL APPLICATION INFORMATION4 DESCRIPTION OF 191fORK CONTRACT PRICE OF WORK:$ 27,485.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 1934006 -Installation of (176) telecommunication cables. 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:176 SELECT SCOPE(REQUIRED): 0 Data ❑ Intercom El 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): 4 i CODE COMPLIANCE q,, ,, IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: El NO ❑YES--See Below&Pg.2 Ti 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 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. : = CONTACT INFORNIAT ON OWNER NAME: TENANT BUSINESS NAME(If Commercial): Fluke HQ OWNER MAILING ADDRESS: STREET 6920 Seaway Blvd, Everett STATE �•�/��A z,p 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Titan Electric CONTRACTOR ADDRESS: STREET 12828 Northup Way Suite 205 crry Bellevue STATE WA ZIP 98005 CONTRACTOR PHONE:206.633.2811 CONTRACTOR EMAIL:permits@titanelectric.net CONTRACTOR LIC.#(REQUIRED):TITANEI963OB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 51191 PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206.633.2811 Tim Pierson CONTACT EMAIL:permits©titanelectric.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 R W and 296.200 WAC. City of Everett Official Use Only PERMIT�#::: 12/27/2019 E \ \ \fl Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application