2823 COLBY AVE STARBUCKS 2019-11-01

ErECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwagov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2823 Colby Avenue BUILDING AREA: 1000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 978 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Remove current bathroom wall fixtures, Install new Dyson hand dryer, terminate existing electrical outlets in restroom, install blank cover. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ 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 ❑Secure Access El Security System El 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: 0 NO El 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: ENO 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 INFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial): Starbucks#3319 OWNER MAILING ADDRESS: STREET 2823 Colby Avenue CITY Everett STATE WA zip 98201 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Mastercraft Electric, Inc. CONTRACTOR ADDRESS: STREET 206- Frontage Rd N CITY Pacific STATE WA ZIP 98047 CONTRACTOR PHONE:253-737-4367 CONTRACTOR EMAIL:garyd@ITlastercraftinc.com CONTRACTOR LIC.#(REQUIRED):MASTEE1127B8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 055704 PRIMARY CONTACT: DOWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-295-0089 KIM DARLING CONTACT EMAIL:kind MaSterCraftlnC.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#: Digitally signed by Kim D E Kim D DN cn=KimD,o,ou, nseD __ ,3� 1nD,o, lve7\ Date"zot9.to.tsztoz:oe-o7oo� 10/15/19 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application