|
ELECTRICAL pet MIT 8FIRE ALARM. PEf
<br /> IT APPLICATION
<br /> #1.111111.: CITY OF EVERETT PERMIT•SERVICES
<br /> 3200 CEDAR ,WAS8201
<br /> • ,STREET EVERETT, ,
<br /> (P)426.257-8810 1 FAX 42.-257-S867 f(E)everetteppeeverettWa.Ov 1 WWw,,eVeretttiva.gevi*rmits
<br /> AI
<br /> etktAitti4640044
<br /> 1, f,.-.;•:,:.' '.'-'1'-z!--.'":''''''''''''.'
<br /> . ''',"I''''''' -'-:f-•, ''''''''''''-'''''' - "-' '''''.''..... • .','' _?..t, - ,,,-----:) .:.,.,.H......-.., ,---... ,, ,...,.- -t*,:-
<br /> PROJECT ADDRESS;l 1127 Evergreen Way South.Everett,WA.95204
<br /> PROJECT TYPE: 0-.NEW CONSTRUCTION I:1 ADDITION 0 TENANT IIVIPROVMENT 0 REMODEL
<br /> BUILDING USE 0 SFR El TovvNHousE 0 DUPLEX 0 ADU 'D MULTI-FAMILY-*Or UNITS' E3 COMMERCIAL
<br /> - - ; - , .... '
<br /> BUILDING.AREA:, sa sq ft:
<br /> ::-Miatd7;ititiXL;5AOftj#Ai10NT(ikoltttii:AtiioN': ',,--,-f::-i:::,,g--7,--1: '',''::- :'''':"'' t''*::::'"74,7-
<br /> CONTRACT PRICE OFINORK:S1,54000 ASSOCIATED BUILDING PERMIT It(If-applicable)::
<br /> , . , ... .
<br /> IS THIS LOW VOLTAGE vioRK? El NO _ , -..-.3-It OF DEVICES:I)
<br /> .
<br /> . . A r-i
<br /> IS THIS A FIRE ALARM PERMIT? Irm-I NO 1--1 YES-Plans required for review(El0,Etepeficat and fire Department Inspections are required)
<br /> - - !
<br /> ;''''i'tottikketv. . .-i',„,i,,,t,r-'11.',,' ,-,, -.''•'-',,,.,‘-,‘ ‘', -•,.':',i '
<br /> DESCRIPTION OF WORK: Disconnect2)ATM's and extend Branch arid.Gorrim conduits for Raw ATM and recenriedt
<br /> r
<br /> IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO DYES-See Below&Pg.2
<br /> Sy checking thisbox, am at
<br /> I sting that I have read and urtderstand!,411 of VI/AC'2,9646B4pd,aelerdadthe‘speOific reason on-page 2
<br /> 1:1 Of thi. application(see next page),AND Plan Review is NOT required because I Meet all of the followingalb Seeders that do not -;
<br /> See Page-2 require Plan Review. r„,. ,,_:„.
<br /> ARE YOU AN OWNER PERFORNIING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL afiNd. DYES.See Below&Pg,3 i
<br /> nPurauantto ROW 19.28,261,property owners and leaseholderscannot perform electrical work en buildings for rent,sale,or lease without I
<br /> the proper electrical licensing and certification,or exemption.By checking this box,I an elating that I have completed and signed the
<br /> See page,3 AFFIDAVIT on page3,of this application to,receivaart exemption fibril'oft abetting/Certification requirement.
<br /> ,
<br /> - ,
<br /> ''''' ''''';',',-"''''','',' ," '""''" " •-'-'''": ''" - - • ,,•' • ' ri. *piker',iparrkapplip44,4pip ,,,,,,,,,F,,,,,-,,,,„7,-,--,‘ :•:;•• . ,,,,••• ,,,,, -„,w,-,,,,,.??,,,,vm,,,,g,,,, „ ,
<br /> ,'• -1,., -.'''' '''!:',',,:,' --:.' ',,i;,2,',,' • 'J, , : ' l,"'.., -1,..„,..."-'7 !!V„7„,. !'17',f,"7",:;',-, ---,--a',-,<,t',.','.-",'':-.;Za,,,,,,,,;',•',,•'•,' '•,•,;•,,s,,,, ••,,,,, =:.;„..-41,,,,,,,,,:,:t,,,;:,,,,,,,,-:, - :
<br /> OWNER NANIE:,charlia Dison TENANT BUSINESS NAME.(If Commercial): BEOU ,
<br /> OWNER.MAILING ADDRESS: STREET 11127 Evergreen Way South.,
<br /> do EverettWA
<br /> STATE ,
<br /> 98204
<br /> ZIP ,
<br /> OWNER PHONE: OWNEREMAIL:
<br /> CONTRACTOR NANIE.:J.WII Eletlric-DBA TalldglIP Ele0IrIc ,!
<br /> ,,. ,
<br /> CONTRACTOR ADDRESS: sr 13708 24th St E,:d.13102
<br /> diy,Sumner ' STATE WA zip-98390 i::
<br /> CONTRACTOR PHONE 253-3958806 courRAcToR Emit:infeatandemelectric.com
<br /> 1
<br /> CONTRACTOR Lta.,#(REctuiRED)r,JwaELIO4Lw „ CITY OF EY#NETT BUSINESS LIC #(REQUIRED):
<br /> PRIMARY CONTACT: DOWNER E1 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME:, CONTACT PHONE 253-202-616$
<br /> ,
<br /> Keith Lynn . ....
<br /> . . .. . . .-- .
<br /> CONTACT EMAIL:keith@tandentelectricmtn '
<br /> AGREEMENT:I hereby certify that thaw read and'examined this application end know the same lobe true and-Corrat. Ali previsions of iirvy.andordinancet -.
<br /> &rimming This type of work wilfile eon's:gated wiSliter specified herein'or not. The grontingoia permit drx0,401 presume.to giVeleitho44 vietare or earteetthe
<br /> pmvisiene,,efehy etherersie or local law regulating eonsinietien,er the performance of oanstnrotion. That I am authorized by the owner of this property to pet*tm the
<br /> work for which application-is made and:I co ply with theState.OantractOrs Low fe.;7 Ftditil and 296;200 W449.
<br /> I/1". . , PERMIT ctty-of Everott 0186101 Use Only,
<br /> , ,
<br /> '.,-,>"(ff ' ,e
<br /> 0wner/Authori/ed Agent!,!,natureD (Revised 1//00.tili Pagftt-APPticatIon
<br /> iattlfil 11
<br />
|