1420 80TH ST SW D BIRDWELL MACHINE 2025-03-11

4:77. tLECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 l FAX 425-257-8857 I (E)everetteps@everettwa gov I www everettwa gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 420 80th St SW Ste D BUILDING AREA: _sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE CI DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 5100.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Add Audible Visual appliances for fire alarm tenant improvement 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: 14 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat E 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) CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO U YES--See Below&Pg. 2 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: ONO 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 INFORMATION OWNER NAME: Birdwell Machine LLC TENANT BUSINESS NAME(If Commercial): Birdwell Machine LLC OWNER MAILING ADDRESS: STREET 17445 NE 70th St Ste 160 crrr Redmond STATE WA ZIP 98052 OWNER PHONE:425-881-1916 OWNER EMAIL: CONTRACTOR NAME: B&H Fire and Security, LLC CONTRACTOR ADDRESS: STREET PO Box 3711 CITY Arlington STATE WA ZIP 98223 CONTRACTOR PHONE:425-244-1445 CONTRACTOR EMAIL:Jeff@BNHFire. Corn CONTRACTOR LIC.#(REQUIRED):BHFIRHF842KW JCITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055697 PRIMARY CONTACT: ❑OWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-244-1445 Jeff Brossard CONTACT EMAIL:Jeff@BNHFire.corn AGREEMENT.I hereby certify that/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#: (/,, Jeff Brossard 09/14/2020 E r 1, '4.-. Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application