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ELECTRICAL Fi MIT & FIRE ALARMII"I '`MIT APPLICATION
<br /> CITY OF EVERETT PERMIT SEI IU�S
<br /> / _ 3200 CEDAR STREET, EVERETT,WA 98201
<br /> `�► (P)425-257-8810 I FAX 425-257-8857 J(E)everetteps@everettwa.gov f www.everettwa.gov/permits
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<br /> PROJECT ADDRESS:3003 W Casino Rd, Bldg 40-26.4, Everett WA 98204
<br /> PROJECT TYPE:[}NEW CONSTRUCTION i■ ADDITION ® ENANT IMPROVMENT REMODEL
<br /> BUILDING USE: Erfli FR CI TOWNHOUSE ❑ S UPLEX El DU 0 MULTI-FAMILY-#OF UNITS: raCOMMERCIAL
<br /> BUILDING AREA: 2000 sq ft
<br /> INFORMATION,sswIP
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<br /> CONTRACT PRICE OF WORK:$2200 ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> IS THIS LOW VOLTAGE WORK? 0 NO 0 YES=#OF DEVICES: 8
<br /> 15 THIS A FIRE ALARM PERMIT? LI 0 © YES-Plans required for review(Both Electrical and Fire Department inspections are required)
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<br /> DESCRIPTION OF WORK: Install access controls for(2)Doors
<br /> Titan Electric job#1936017
<br /> THIS SECTION APPLIES TO ALL EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES:
<br /> ❑ By checking this box,I am stating that I have read and understand all of WAC 29646B-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 /> iiiPursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease without
<br /> I 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.
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<br /> OWNER NAME: Boeing TENANT BUSINESS NAME(If Commercial): Boeing
<br /> OWNER MAIUNG ADDRESS: STREET 3003 W Casino Road
<br /> cny Everett STATE WA ma 98204
<br /> OWNER PHONE: 312 544 2000 OWNER EMAIL:
<br /> CONTRACTOR NAME: Titan Electric
<br /> CONTRACTOR ADDRESS: STREET 12828 Northup Way,Suite 205
<br /> Bellevue STATE WA zip 98005
<br /> CONTRACTOR PHONE:206 633 2811 CONTRACTOR EMAIL: perrnits@titanelectric.net
<br /> CONTRACTOR UC.#(REQUIRED):T rn'El963O8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051191
<br /> PRIMARY CONTACT: ®OWNER ,)' ONTRACTOR 1 O'OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 206 551 7253
<br /> Sean Hughes CONTACT EMAIL: seanh@titanelectric.net
<br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and coned. 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 I am authorized by the owner of this property to perform the
<br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and 298.200 WAC.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> A/// -.. 2.6-71 g\. '‘OZ - 0 (0
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<br /> Owner/Authorized Agent Signature Date (Revised 10/30/2018)
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