3003 W CASINO RD BLDG 40-12 2019-10-31

E 7TRICAL PERMIT APPLI ION CITY OF EVERETT PERMIT SERVICES 04T7' 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 PROD "CTIITE INFORMATIOW ' it PROJECT ADDRESS: 3003 W CASINO RD., BLDG 40-12 (BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL • . :R1CAL4111CAT PT1 a1* MDQ \ CONTRACT PRICE OF WORK:$ 6,500.86 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: REMOVE AND REPLACE LIKE-IN-KIND 12V 34 WATT PER CELL BATTERIES IN 2 UPS SYSTEMS. BOTH UPS SYSTEMS HAVE 4 STRINGS OF 16 BATTERIES IN PARALLEL, 222 VDC CIRCUIT. STRINGS ARE LOCATED IN BATTERY CABINETS INTERNAL TO THE UPS. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio El 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): BATTERY BACKUP POWER FOR STEAM PLANT CONTROLS IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARFACILITIES: ✓ NO\ vn 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 YOUAN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ❑✓ NO EYES-See Below& Pg. 3 nI I 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. OWNER NAME: BOEING TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3003 W CASINO RD., BLDG 40-12, BOILER STEAM PLANT CITY EVERETT STATE WA ZIP 98024 OWNER PHONE:(425)330-7349 OWNER EMAIL:SCOTT.BLYMYER@BOEING.COM CONTRACTOR NAME: EATON CORPORATION 0 of of tb Q7,0 CONTRACTOR ADDRESS: STREET 13205 SE 30TH ST, SUITE 101 CITY BELLEVUE STATE WA ZIP 98005 CONTRACTOR PHONE:(509)347-6308 CONTRACTOR EMAIL:TRAVISJJOHNSON@EATON.COM CONTRACTOR LIC.#(REQUIRED):07E EATONC*844D1 ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 56707 PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:(425)330-7349 Scott Blymyer CONTACT EMAIL:SCOTT.BLYMYER@BOEING.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#: Johnson oh nSon DDatea201 07211byTravis J 800'n E ic102.- 0c11 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application