9001 AIRPORT RD 2020-01-21 - Laserfiche WebLink

ELECTRICAL PERMIT APPLILATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 9001 Airport Road Everett BLDG 4, WA 98206 BUILDING AREA: 16.000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION O TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL ELECTRICAL APPLICATIONINFORMATION 8,DEseRIPTIO or,i0ORK CONTRACT PRICE OF WORK:$ 8,600 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Installing connections for relocated washer and dryer. Upgrading panel 'S'. Sawcutting for trench. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder 0 Circuits-#:2 ❑ Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑Secure Access ❑ 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): IS THIS PERMIT EDUCATION,INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: L j NO 0 YES--See Below&Pg. 2 ✓ By checking , I am stating that I have read understand all of 4B-900,selected the specific reason on page 2 of this applicationthisbox(see next page),AND Plan Reviewand is NOT required WAC because296-I me6et 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 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 See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. zG t.••CONTACT OR IIA' ION ,•�.u..0 c a.,� ,�..,tea�s„. e ha \��\iii OWNER NAME: Mukilteo School District TENANT BUSINESS NAME(If Commercial): SNO-ISLE Skills Center OWNER MAILING ADDRESS: STREET 9401 Sharon Drive CITY Everett STATE WA ZIP 98204 OWNER PHONE:425-3 - OWNER EMAIL:StefansonKl@mukilteo.wednet.edu CONTRACTOR N E: NA CONTRACTOR ADDRESS: REET CITY STATE ZIP CONTRACTOR PHO : CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑✓OTHER(Please Specify) Engineer CONTACT NAME: CONTACT PHONE:253-922-0446 Ben Hedin CONTACT EMAIL:ben.hedin@bceengineers.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#: Ben Hedin 7/31/19 E l c Og -oo Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application