221 SE EVERETT MALL WAY RED WING SHOES 2019-03-21

ELECTRICAL PERMIT 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 1 www.everettwa.gov/permits OLT ,,: PROJECT "ITE INFORMATION ,, ,-,„,v,,,, ,,„-.‘-:,. PROJECT ADDRESS: 221 SE EVERETT MALL WAY BUILDING AREA: 1500 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL ELECTRICAL APPL CATION IINFORMATION&DE RIPTIIION OF WORK CONTRACT PRICE OF WORK: $ 1402 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: INSTALL NEW INTRUSION SYSTEM AND CCTV 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:11 SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑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):CCTV CODE CC1 INC ? IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑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: ENO 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. „Z g \ C ,CONTACT INFOR,. 0w. , OWNER NAME: IVERIFY TENANT BUSINESS NAME(If Commercial): REDWING SHOES OWNER MAILING ADDRESS: STREET 8180 UPLAND CIRCLE CITY CHANHASSEN STATE MN Z,P 55317 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: WHITE SECURITY SYSTEMS INC CONTRACTOR ADDRESS: sTREET12617 108TH AVE NE c,Tv ARLINGTON STATE WA ZIP 98223 CONTRACTOR PHONE:425-402-0366 CONTRACTOR EMAIL:WSSI@WHITESECURITY.COM CONTRACTOR LIC.#(REQUIRED):WHITESSO44JP CITY OF EVERETT BUSINESS LIC.#(REQUIRED):037276 PRIMARY CONTACT: El OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME:HEATHER CONTACT PHONE:425-402-0366 CONTACT EMAIL:HEATHER@WHITESECURITY.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 PERMIT#: Heather foster 2-13-19 E V Z- v Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application