3200 CEDAR ST 2023-09-25 - Laserfiche WebLink

tLECTRICAL PERMIT APPLI ATION 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 477. PROJECT ADDRESS: 3200 Cedar St Annex 4 BUILDING AREA: 200 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL ELECTRICAL AP ,;R.. NON INFOIFOISATIOWA D►ESCRI. i ,OF RK CONTRACT PRICE OF WORK: $ 1000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Replacing non listed dialer with a fire alarm panel for sprinkler monitoring. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO El YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑ Audio ❑ Secure Access ❑ Security System 0 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): a CODE` LiANNNC . IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIE S: ❑ NO 1 YES--See Below&Pg.2 ❑ By tchhies cakipnpgl itchaitsi obon x(,s Ie ae mn exat tipnag he)a,tA IND vPe lraea R eavniew u nisd eNrOtT nrdeq aull rofd WbAcCa u2s9e6-I 4m6eBea0ll,osf etlheec fteldlo twien gs se ifseicc rtieoass otna ot nd op ange 2 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. ria ONTAGT,NN Amm ''N ,. OWNER NAME: City Of Everett TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3200 Cedar St cry Everett STATE WA ZIP 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Western States Fire Protection CONTRACTOR ADDRESS: STREET 14690 NE 95th St#101 CITY Redmond STATE WA ZIP 98052 CONTRACTOR PHONE:425-881-0100 CONTRACTOR EMAIL:seth.zehnder@wsfp.us CONTRACTOR LIC.#(REQUIRED):WESTESF906P1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ['OTHER(Please Specify) 020553 W CONTACT NAME: CONTACT PHONE:425-478-9709 Seth Zehnder CONTACT EMAIL:seth.zehnder@wsfp.us 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#: E2001 - ItA2 Owner/Aut ri 7/2/2020 d Agent Signature Date (Revised 1/11/2019) Page 1-Application