905 WETMORE AVE EVCC NIPPON BUSINESS INSTITUTE 2019-06-25

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps©everettwa.gov I www.everettwa.gov/permits OLT PROJECT SITE INFORMATION PROJECT ADDRESS:905 Westmore Avenue, Everett, 98201 - Everett community College Nippon Business Institute PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION '--- , CONTRACT PRICE OF WORK: $1,000 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? ❑ NO ❑✓ YES-#OF DEVICES:2 IS THIS A FIRE ALARM PERMIT? ✓❑ NO E YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Install (2) Low Volt Thermostats IS THIS PERMIT EDUCATION, INSITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO El YES--See Below&Pg. 2 fl 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: 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: State of Washington-Department of Enterprise Services TENANT BUSINESS NAME(If Commercial): EvCC Nippon Business Institute OWNER MAILING ADDRESS: STREET 1500 Jefferson Street ci,, Olympia STATE WA Zip 98504 OWNER PHONE:360-701-9545 Susan Smith, PE OWNER EMAIL:susan.smith@des.wa.gov CONTRACTOR NAME:D.K. Systems, Inc. CONTRACTOR ADDRESS: STREET PO Box 886/962 S. Spruce Street cin Burlington STATE WA ZIP 98233 CONTRACTOR PHONE:360-755-1555 CONTRACTOR EMAIL:shayes@dksystemsinc.com CONTRACTOR LIC.#(REQUIRED):DKSYSI*982L1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 049744 PRIMARY CONTACT: ❑OWNER I]CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:360-391-5338 Steve H ayes CONTACT EMAIL:shayes@dksystemsinc.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# 3 OL( o Dulce Herrera Date 019030609wce4-08'0 l ,`9 0 Date:tow 9.o9 by Duke Herrera oo 03-06-2019 Owner/Authorized Agent Signature Date (Revised 11/5/2018) Page 1-Application