2300 MERRILL CREEK PKY BASE FILE 2023-12-08

• • IneN ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WA81{IHOTon (P)425-257-8810 I(E)PermitServices@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:2300 Merrill Creek Parkway BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION TENANT IMPROVMENT ❑REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$972.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: The Scope is to replace main board for the existing Fire Alarm system The Scope is to replace main board for the existing Fire Alarm system 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? IEl NO ❑✓ YES-#of Devices:1 SELECT SCOPE(REQUIRED): Data ❑Intercom 0 Thermostat ❑Audio ❑Secure Access ❑Security System Q 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: L; NO Li YES--See Below&Pg.2 EVA By checking this box,I am stating that I have read and understand all of WAC 296.46E-900,selected the specific reason on page mAl 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: NO OYES-See Below&Pg. C 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. 4 CONTACT INFORMATION OWNER NAME:JSH Properties TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 209 Olive Way, Suite 1011 CITY Seattle STATE:.WA ZIP 98101 OWNER PHONE:425-283-5472 OWNER EMAIL:christianr@jshproperties:com CONTRACTOR NAME:Fire Systems West, Inc, CONTRACTOR ADDRESS: STREET206 Frontage Rd. N,Suite C WA r� CITY Pacific STATE ZIP 98047 CONTRACTOR PHONE:253-833-1248 CONTRACTOR EMAIL:rodrigoq@firesystemswest.com CONTRACTOR LIC,#(REQUIRED): F(I,& ?W J, .VVJCITY OF EVERETT BUSINESS LIC.#(REQUIRED):022919 PRIMARY CONTACT: [DOWNER OCONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-202-7040 Rodrigo QuiriteroS CONTACT EMAIL:rodrigoq@firesystemswest.com AGREEMENT:!hereby rtify that 1 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 volkki comp ed 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 re ula QQQg co ction or the;performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and l comply with thy Stalk Con ctors Law 18.27 RCW and 296.200 WAC. City of Everett'Official Use Only l PERMIT#: 1(1 ( /2-7— (D 02(4( Owner/Au orb . o Signature Date (Revised 4/512022) Page 1-Application