2235 LAKE HEIGHTS DR 2019-03-28 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES#11111d-----A 3200 CEDAR STREET, EVERETT,WA 98201 . (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:2235 Lake Heights Drive PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$250 ASSOCIATED BUILDING PERMIT#(if applicable): 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) DESCRIPTION OF-WORK A ZODE,COMPLIANCE DESCRIPTION OF WORK: 2-hour load bank test of emeraencv standby Generator set Bethany of the NW Silver Lake-SRO#1902131 IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑NO ❑✓ YES--See Below&Pg.2 OBy 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:ONO 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. CONTACT'INFORMATION OWNER NAME: Bethany of the NW TENANT BUSINESS NAME(If Commercial): Bethany of the NW-Silver Lake OWNER MAILING ADDRESS: STREET PO Box 13700 Mill Creek STATE WA ZIP 98082 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Pacific Power Group CONTRACTOR ADDRESS: STREET805 Broadway Street, Suite 700 CITY Vancouver STATE WA ZIP 98660 CONTRACTOR PHONE:253-395-9077 CONTRACTOR EMAIL:anokes@pacificpowergroup.com CONTRACTOR LIC.#(REQUIRED):PACIFPG867D7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 053000 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Nokes PHONE:253-395-9077 Amanda CONTACT EMAIL:anokes@pacificpowergroup.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!comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# ibwli� E l9a( - olo3 Ow er/ a1 Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application