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ACTRICAL PERMIT APPLIATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I (E)PermitServices@everettwa.gov I www.everettwa.gov/permits <br /> yr PROJECT SITE' NFi ATION <br /> PROJECT ADDRESS:1720 W MARINE VIEW DRIVE BUILDING AREA: 5,799 sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: Q COMMERCIAL <br /> ELECTRICAL,APPU.CATION INFORMATIO 7i 4 • ( i -: OF WORK. , .. ;•: <br /> CONTRACT PRICE OF WORK: $8795 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK:INSTALLATION OF FIRE ALARM NOTIFICATION DEVICES ASSOCIATED WITH THE TENANT IMRPOVEMENT <br /> - INSTALLATION OF FIRE ALARM NOTIFICATION DEVICES ASSOCIATED WITH THE TENANT IMRPOVEMENT <br /> Z <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope. ❑Service ❑Feeder ❑ Circuits-#: I I Complete Re-wire <br /> LOW VOLTAGE WORK? ❑NO ✓❑YES-#of Devices:26 <br /> SELECT SCOPE(REQUIRED) ❑Data ❑Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System <br /> ['Fire 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 /> ( <br /> THISIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO LIYES 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:WINO nYES-See Below&Pg. <br /> ❑ <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 /> /x �f #`Ff �RIfATION <br /> OWNER NAME:PORT OF EVERETT TENANT BUSINESS NAME(If Commercial): EVERETT YACHT CLUB <br /> OWNER MAILING ADDRESS: STREET PO BOX 538 <br /> CITY EVERETT STATE WA ZIP 98206 <br /> OWNER PHONE: OWNER EMAIL: <br /> • cam ,.., s;, >e... <br /> CONTRACTOR NAME:B&H FIRE AND SECURITY <br /> CONTRACTOR ADDRESS: STREET PO BOX 3711 <br /> c,T,, ARLINGTON STATE WA Z,P 98223 <br /> CONTRACTOR PHONE:425-244-1445 'CONTRACTOR EMAIL:JEFF©BNHFIRE.COM <br /> CONTRACTOR LIC.#(REQUIRED):BHFIRHF842KW ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055697 <br /> . . , <br /> PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR MOTHER(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 lam 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 /> � 1/27/2023 E 0 L. <br /> 0 er/Authorized Agent Signature Date (Revised 4/5/2022) Page 1-Application <br />