3700 COLBY AVE EVERETT OPTOMETRY CLINIC 2019-08-07

ELECTRICAL rIRMIT & FIRE ALARM PRMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 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 4677. PROJECT SITE INFORMATION PROJECT ADDRESS: 3700 Colby Ave, Everett, WA 98201 PROJECT TYPE: f]NEW CONSTRUCTION nADDITION RfITENANT IMPROVMENT nREMODEL BUILDING USE: ❑ SFR 0 TOWNHOUSE ItTIDUPLEX ItT\DU 0 MULTI-FAMILY-#OF UNITS: ca COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 14,940 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? 4 NO 0 YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? Ul NO . 0 YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Solar electric System and Feeder THIS SECTION APPLIES TO ALL EDUCATION, INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: F 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: 11:3 Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent, sale,or lease without I u I 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: James Schrader TENANT BUSINESS NAME(If Commercial): Everett Optometry Clinic OWNER MAILING ADDRESS: STREET PO Box 986 CITY Everett STATE WA ZIP 98206-0986 OWNER PHONE: 425-280-7667 OWNER EMAIL: s.schrader@everettoptonmetry.com CONTRACTOR NAME: Fire Mountain Solar, LLC CONTRACTOR ADDRESS: STREET 19388 Periwinkle Lane aTY Mount Vernon STATE WA z,P 98274 CONTRACTOR PHONE: 360-422-5610 CONTRACTOR EMAIL: tial@fmSolar.com CONTRACTOR LIC.#(REQUIRED): FIREMMS835KR CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051373 PRIMARY CONTACT: [Ell 14ONTRACTOR nOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-422-5610 Tim Nelson CONTACT EMAIL: tim©fmsolar.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.# � ��^- // /.2/ /--)62/ .0(6\.'-- \'')A Owner/Authorized Agent Signature Date (Revised 10/30/2018) Page 1 of 3