3003 W CASINO RD BLDG 40-27 2019-09-04

1c2, s,. 403c .001 C 3( c: ) OLTELECTRICAL PERMIT APPLIORTION 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.evereftwa.goviperrnits . .. ` , : ::PROJF�;TSI'["E;'a�MiFO;1RIVaA;TiQ;N� ,: ',.:_:'; : : =;=~:: :;°::.; ,: ; . "'..'._'. :.' �,� .: ..:.,: . • •r UJ PROJECT ADDRESS: r i(1v P A 3.4. // 14 BUILDING AREA: 440, —1 COI " sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL IBUILDING USE: El SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL a. ELECTRICAL APPLICAT O T „. . .. . L..:N.INFOR A,T�Q. .. >-.B�:.D. Sr.0 I :.::TION_:O 'iiVO ... ,�:::' '_=:;: `. ;:: :* ;:; CONTRACT PRICE OF WORK:$ )r,CDPOO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: P-fry - (U1-1l f 1 / _�5.1-�lpelta.- ci1 �--.1(i�.A.a-- bY) inn ica r _a t-e -1-�'gs,.�4C_ THIS INSTALLATION INCLUDES THE FOLLOWING� SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO E 'YES-Select Scope: CI Service LWFeeder IIrcuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑Intercom ❑Thermostat ❑Audio El Secure Access El Security System . . ❑Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system,An additional Fire Alarm Permit is required for review of device location and installation approval. ❑Other(List All): G P ''.iA THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ❑ NO El YES--See Below&Pg.2 • — By checking this box, l 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 see Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. .. CONTACT:. ::. - - �.. 1 . FCIt1� T ,,.. :. . A . OWNER NAME: TENANT BUSINESS NAME(If Commercial): Boeing OWNER MAILING ADDRESS: STREET PO Box 3707 CITY Seattle STATE WA Zip 98124-2207 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: General Construction Company k`.ONTRACTOR ADDRESS: STREET PO Box 46 t. CRY MUkilte° STATE WA zip 98204 CONTRACTOR PHONE:425-294-6944 CONTRACTOR EMAIL:Bridgett.Burns@kiewit.com CONTRACTOR LIC.#(REQUIRED):GENERCC984OZ CITY OF EVERETT'BUSINESS LIC.#REQUIRED):040599 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ['OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-730-6546 Dennis Crow CONTACT EMAIL:Dennis.crow@kiewit.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 lam authorized by the owner of this properly to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAG. City of Everett Official Use Only d PERMIT#: �t,t6-..__ ) E -- Ow erlAuthorl•;iiAgent S tura Date (Revised 1/11/2019) Page-Application