10200 19TH AVE SE COSTCO BAKERY 2019-11-15

ELECTRICAL PERMIT & FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES "111P(eSVZ----A Vdgi3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:10200 19th Ave SE PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION El TENANT IMPROVMENT 0 REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: RI COMMERCIAL BUILDING AREA: sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $24,000.00 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? El NO ❑ YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? El NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Bakery department equipment upgrades and replacement of (3) ovens (1) proof box (3)exhaust fans (4)transfer fans and (1) pit washer. IS THIS PERMIT EDUCATION,INSITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 17 NO ❑YES--See Below&Pg.2 1-71 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 rI 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: 1-71NO DYES-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 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:Costco Wholesale TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET999 Lake Drive cin. Issaquah STATE WA ZIP 98027 OWNER PHONE:425-313-8100 OWNER EMAIL: CONTRACTOR NAME:Trig Electric Service, Inc. CONTRACTOR ADDRESS: STREET1 121 Rainier Ave S ciTY Seattle STATE WA ziP 98144 CONTRACTOR PHONE:206-328-0555 CONTRACTOR EMAIL:jmUIlins@trigelectriC.COm CONTRACTOR LIC.#(REQUIRED):TRIGESI054R1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 16392 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-328-0555 Jeffrey Mullins CONTACTEMAIL:jmullins@trigelectric.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# ham,. — 12/13/2018 G\,°t.0-1—(P1 Owner/ uthorizq Agent Signature Date (Revised 11/5/2018) Page 1-Application