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ELECTRICAL PlitMIT & FIRE ALARM PUP MIT APPLICATION <br /> CITY OF EVERETT PERMIT SEMMES <br /> "111P47V-----A <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3003 W Casino Rd, Bldg 40-87, Everett WA 98204 <br /> PROJECT TYPE:ANEW CONSTRUCTION ,I ADDITION ca ENANT IMPROVMENT (REMODEL <br /> BUILDING USE: 11,SFR 0 TOWNHOUSE 0 DUPLEX 0 DU 0 MULTI-FAMILY-#OF UNITS: Ira COMMERCIAL <br /> BUILDING AREA: 2000 sq ft <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 2000 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> IS THIS LOW VOLTAGE WORK? 0 NO ® ES-#OF DEVICES: 10 <br /> IS THIS A FIRE ALARM PERMIT? [ 0 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) <br /> DESCRIPTION OF WORK & CODE COMPLIANCE <br /> DESCRIPTION OF WORK: Install Access Control Devices for(2)Doors.Install Access control panel and power supply,120v by others <br /> Titan Electric job#186243 <br /> THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: <br /> Tau 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 <br /> 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 /> ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: <br /> I N I Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without <br /> the proper electrical licensing and certification,or exemption.By checking this box,I am stating that I have completed and signed the <br /> See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing TENANT BUSINESS NAME(If Commercial): Boeing <br /> OWNER MAILING ADDRESS: STREET 3003 W Casino Road <br /> ^ <br /> ciry Everett STATE WA ZIP 98204 <br /> OWNER PHONE: 312 544 2000 OWNER EMAIL: <br /> CONTRACTOR NAME: Titan Electric <br /> CONTRACTOR ADDRESS: STREET 12828 Northup Way,Suite 205 <br /> CITY STATE STATE WA ZIP 98005 <br /> CONTRACTOR PHONE: 206 633 2811 CONTRACTOR EMAIL: permits@titanelectric.net <br /> CONTRACTOR LIC.#(REQUIRED): TITANEI963OB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051191 <br /> PRIMARY CONTACT: OWNER PTONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206 551 7253 <br /> Sean Hughes CONTACT EMAIL: seanh@titanelectric.net <br /> AGREEMENT:t 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 <br /> 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 <br /> provisions of any other state or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the <br /> work for which application is made and!comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> / PERMIT#`^xy' t t\ C <br /> 1 2- //—/r E k V 1 2 <br /> Owner/Authorized Agent Signature Date (Revised 10/30/2018) ♦♦ wJ <br />