111 SE EVERETT MALL WAY WA VOCATIONAL SERVICES 2019-10-02

ELECTRICAL FORIMIT & FIRE ALARM PAILIIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS:111 SE Everett Mall Way, Bldg. C#100 PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL BUILDING AREA: 8000 sq ft CONTRACT PRICE OF WORK:$2,032.00 ASSOCIATED BUILDING PERMIT#(if applicable):N/A IS THIS LOW VOLTAGE WORK? ❑ NO ❑YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ❑ NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) iiire. i P MA QtdkiaLo ..,��.3 € 1",146 dhhiffaithigkifibibi�pp DESCRIPTION OF WORK: Install 2 1000w, 120v heaters and programmable SP t-stats. One in each restroom. IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO ❑YES--See Below&Pg.2 I I 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:LINO 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. 11:10:1 _. a x: Z4_,.. , .,.... . **S Vt .., t., ��,`V1.�„��z,��° .. OWNER NAME:Sue Lesh TENANT BUSINESS NAME(If Commercial):Washington Vocational ServicE OWNER MAILING ADDRESS: STREET111 SE Everett Mall Way, Bldg. C#100 CITY Everett STATE WA ZIP 98208 OWNER PHONE:(425) 320-6965 OWNER EMAIL:Slesh@wvs.org CONTRACTOR NAME:Seahurst Electric CONTRACTOR ADDRESS: sTREET2915 Chestnut St. CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE:(425) 258-1882 CONTRACTOR EMAIL:reception@seahurst.com CONTRACTOR LIC.#(REQUIRED):SEAHUEI099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425) 258-5143 Dave LeBlanc CONTACTEMAIL:dleblanc@seahurst.com 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 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 PE # x477David J.LeBlanc � m„p,�,,;�5""---°'"°— 1-8-19 Owner/Authorized Agent Signature Date (Revised 11/6/2018) Page 1-Application