426 E CASINO RD 2019-10-31 - Laserfiche WebLink

ism uzi ELECTRICAL PERMIT APPLICATION EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 426 East Casino Road BUILDING AREA: N/A sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ✓❑ ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL • EL*CTRICAIL APPLICATION INFORMATION & DESCR PTFON OF WORK CONTRACT PRICE OF WORK: $ 9,850.00 ASSOCIATED BUILDING PERMIT#(if applicable): N/A DESCRIBE SCOPE OF WORK: Provide (6) L6-30R Power whips, Provide (6) Q0B230 Breakers Provide (2) CS8369L Power Whips and receptacles, Provide (2) Q0B350 Breakers Terminate in Existing PDU'S THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ✓❑ Circuits-#:8 ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑Audio ❑ Secure Access ❑ 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: NO ❑YES--See Below&Pg.2 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: ✓❑NO 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. •• ..: CONTAT INFOR . OWNER NAME: Frontier Communications TENANT BUSINESS NAME(If Commercial): Frontier Communications OWNER MAILING ADDRESS: STREET 100 CTE Drive c,,, Dallas STATE PA ZIP 18612 OWNER PHONE:(946) 646-9188 OWNER EMAIL:Carla.dean@ftr.com CONTRACTOR NAME: Seahurst Electric, Inc. CONTRACTOR ADDRESS: STREET2915 Chestnut St. CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE:(425) 258-1882 CONTRACTOR EMAIL:dleblanc@seahurst.com CONTRACTOR LIC.#(REQUIRED):SEAHUEI099QN CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 18763 PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425) 258-5143 Dave LeBlanc CONTACTEMAIL:dleblanc@seahurst.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#: David J.LeBlanc ...,,, ..._�...a. 1-1.1 9-25-19 E O9 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application