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ELECTRICAL FIMIT & FIRE ALARMII MIT APPLICATION CITY OF EVERETT PERMIT SERV 2,ES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits OLT PROJECT SITE INFORMATION _., �..w..�. ..�, PROJECT ADDRESS: 9001 Airport Road Everett, WA 98204 o 'ZV I 2 ii- . PROJECT TYPE: ❑ NEW CONSTRUCTION a ADDITION nTENANT"IIMPROVMENT ❑REMODEL BUILDING USE: [TI SFR 0 TOWNHOUSE DUPLEX ri4DU 0 MULTI-FAMILY-#OF UNITS: [COMMERCIAL BUILDING AREA: 16,000 sq ft AL APPLICATION INFORMATION _ CONTRACT PRICE OF WORK:$ A ASSOCIATED BUILDING PERMIT#(if applicable): NA IS THIS LOW VOLTAGE WORK? 0 NO ❑ ES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? 0 ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK &CODE COMPLIANCE DESCRIPTION OF WORK: Installing connections for publications equipment and computer to an existing panel. THIS SECTION APPLIES TO ALL EDUCATION, INSITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 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. ATTENTION OWNERS:THIS SECTION IS FOR OWNERS PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: I■I 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: Mukilteo School District TENANT BUSINESS NAME(If Commercial): SNO-ISLE Skills Center OWNER MAILING ADDRESS: STREET 9401 Sharon Drive ciry Everett STATE WA ZIP 98204 OWNER PHONE: (425)356-1274 OWNER EMAIL: CONTRACTOR NAME: Bonner Electric CONTRACTOR ADDRESS: STREET 1419 Dike Road CITY Mount Vernon STATE WA zip 98273 CONTRACTOR PHONE: 360-899-9540 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ DWNER CONTRACTOR ©OTHER(Please Specify) Engineer CONTACT NAME: CONTACT PHONE: 253-922-0446 Ben Hedin CONTACT EMAIL: ben.hedin@bceengineers.com AGREEMENT:1 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# Ben Hedin 3/25/19 bl 1'tO3- i0'i Owner/Authorized Agent Signature Date (Revised 10/30/2018) Page 1 of 3