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,r--1 <br /> EL CTRICAL PERMIT APPLICFION5 ECEUVEI <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 CEDAR STREET, EVERETT,WA 98201 p A <br /> (P)425-257-8810 I(E)PermitServices@everettwa.gov I wAw.everettwa.gov/permit- I MAY 0 5 8 <br /> WASHINGTON <br /> "� ,i �d/2 °" Xl,-tee �"`^-;; '`. :i «F ✓ e ta,g: <br /> PROJECT ADDRESS:1712 W MARINE VIEW DRIVE BUILDING AREA: 2032 1.2t1 r -• I.- <br /> �,t 11I;;'t <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION E TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: El SFR ❑TOWNHOUSE ❑DUPLEX El ADD ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIA <br /> CONTRACT PRICE OF WORK: $3,150 ASSOCIATED BUILDING PERMIT#(if applicable): L'G'24 j0( - t)fls' <br /> DESCRIBE SCOPE OF WORK: FIRE ALARM FOR THE TENANT IMPROVEMENT .. <br /> FIRE ALARM FOR THE TENANT IMPROVEMENT <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope:❑Service ❑Feeder ❑ Circuits-#. ❑Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO 0 YES-#of Devices:25 <br /> SELECT SCOPE(REQUIRED) ❑Data ❑Intercom ❑Thermostat El Audio ❑Secure Access ❑Security System <br /> EFire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An <br /> additional Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: © NO NI YES—See Below&Pg.2 <br /> ❑ 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 <br /> 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 <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE:ONO EYES-See Below&Pg. <br /> ® Pursuant to RCW 19.28.261, property owners and leaseholders cannot perform electrical work on buildings for rent, sale,or lease <br /> without the proper electrical licensing and certification,or exemption. By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> e <br /> OWNER NAME:TAYLOR HERMAN TENANT BUSINESS NAME(If Commercial): PORT GARDNER LANDII <br /> OWNER MAILING ADDRESS: STREET )0:0n S CAO � <br /> CITY STATE ZIP <br /> OWNER PHONE:360-393-7553 OWNER EMAIL:TAYLOR@WOODSCOFFEE.COM <br /> CONTRACTOR NAME:B1H FIRE AND SECURITY 7 t <br /> CONTRACTOR ADDRESS: STREET PO BOX 3711 <br /> CITY ARLINGTON STATE WA ZIP 98223 <br /> CONTRACTOR PHONE:425-244-1445 CONTRACTOR EMAIL:JEFF@BNHFIRE.COM <br /> CONTRACTOR LIC.#(REQUIRED):BHFIRHF842KW CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055697 <br /> PRIMARY CONTACT: DOWNER ❑� CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-244-1445 <br /> JEFF BROSSARD CONTACT EMAIL:JEFF@BNHFIRE.COM <br /> 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 <br /> 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 <br /> or local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> �� , �z 5/2/2023 E , �o 5 -0 g <br /> Owner u •. zed Agent Signature Date (Revised 4/5/2022) Page 1-Application <br />