10821 19TH AVE SE PNW PHYSICAL THERAPY 2019-07-25

4LT ELECTRICAL 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 PROJECT SITE INFORMATION PROJECT ADDRESS:10821 19th Ave SE, Suite 102, Everett, WA 98208 BUILDING AREA(if residential, new construction, remodel,or addition)NIA SF N/A BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: E COMMERCIAL USE OF BUILDING:Commercial ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $2800 NUMBER OF DEVICS.lif low voltage):13 FIRE ALARM? ✓ YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Provide parts/smarts/field trim modification to existing fire alarm system in a remodeled group B facility. Installation to include automatic detection, and full occupant notification in tenant improvement are, only. CONTACT INFORMATION OWNER NAME: David Company TENANT NAME(If Commercial): PNW Physical Therapy LLC OWNER MAILING ADDRESS: STREET 19128 11th Ave NW Suite 2-433 CITY Bothell STATE WA ZIP 98011 OWNER PHONE:(206)999-3457 OWNER EMAIL: CONTRACTOR NAME:Washington Alarm CONTRACTOR ADDRESS: STREET 2030 Airport Way S CITY Seattle STATE WA ZIP 98134 CONTRACTOR PHONE:206-436-5300 CONTRACTOR EMAIL:Permits@washingtonalarm.com CONTRACTOR LIC.#(REQUIRED):WASHIA1282C3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):025389 PRIMARY CONTACT: OWNER CONTRACTOR ✓DTHER(Please Specify) Applicant CONTACT NAME: CONTACT PHONE:(206)-436-5315 Eric Ham ers ki CONTACT EMAIL:ehamerski@washingtonalarm.com AGREEMENT:T 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 FEE 1<Y( -21,40 -SD '\496? PERMITr'- # 0\. 12/`t/ - 030 Owner/Auth ized Agent Signature Date (Revised 10/12/2015) /2