10200 19TH AVE SE 2019-07-25 - Laserfiche WebLink

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 j FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.govlperrnits PROJECT SITE INFORMATION PROJECT ADDRESS:10200 19th Avenue SE Everett,WA 98208 PROJECT TYPE: 0 NEW CONSTRUCTION ✓CI,. ADDITION ❑TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL BUILDING AREA: 2400 sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$2000 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? ❑NO ✓❑YES-#OF DEVICES:14 Cat5e data cables IS THIS A FIRE ALARM PERMIT? 0 NO 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK&CODE COMPLIANCE DESCRIPTION OF WORK: Installing 14 cat5e data cables:(1150amo dedicated circuit aoina to load circuit: (3)20amp circuits will come off of the load center to(3)20amp dedicated receptacles inside of the kiosk; (1)non dedicated 20amp circuit for winch installation IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH ANDIOR PERSONAL CARE FACILITIES: d❑NO 0 YES—See Below&Pg.2 ❑ By checking this box,I am stating that I have read and understand ail of WAC 296.468-900,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 OYES-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:COSTCO WHOLESALE CORP TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: sm e-r999 Lake Drive cm. Issaquah STATE WA zip 98027 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Wachter Inc. CONTRACTOR ADDRESS: smREEr 16001 West 99th St. crry Lenexa STATE KS ap 66219 CONTRACTOR PHONE:913-227-3911 ICONTRACTOR EMAIL:permitrequest@wachter.com CONTRACTOR UC.#(REQUIRED):EC WACHTI*904KL CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 043582 PRIMARY CONTACT: ❑OWNER r❑CONTRACTOR ❑OTHER(Please Specify) • CONTACT NAME: CONTACT PHONE:913-227-3924 GJ(sf of 1 - 11 If a' Jared MuIkey CONTACT EMAIL:permitrequest wachter.com AGREEMENT:I hereby certify that t have read and examined this application and know the same to be true and correct. Al!provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a pennit 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 end 296.200 WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent 81 Date (Revised 11/5/2018) Page 1-Application