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3003 W CASINO RD BLDG 40-22 2020-10-22
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3003 W CASINO RD BLDG 40-22 2020-10-22
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Last modified
10/22/2020 8:26:57 AM
Creation date
1/22/2020 8:31:07 AM
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Address Document
Street Name
W CASINO RD
Street Number
3003
Tenant Name
BLDG 40-22
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i -9. 3ooO.001 ((til2J <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> "PW/.":"1 <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE.INFORMATION <br /> PROJECT ADDRESS: L o 2.Z -( t i Vl ('D 1 -7 BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑A (TION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR Cl TOWNHOUSE El DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> (CONTRACT PRICE OF WORK:$ /6/ <br /> J(2)C) ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: a_4,-is 4-c4,1/ //91)/--s #-. 61 c p/ 7 fit vQet <br /> pi0/1.0 1 cr IV&VISFcY~wi r ( 3 +—CO (S ) <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? �❑ NO YES-Select Scope: C } vice Weeder ircuits-#: ❑ Complete Re-wire <br /> LOW VOLTAGE WORK? L� NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat ❑Audio El Secure Access ❑Security System <br /> El Fire Alarm-Installations under this permit only include electrical wiring rough-in of the system.An additional ' <br /> Fire Alarm Permit is required for review of device location and installation approval. <br /> ❑Other(List All): <br /> r . CODE COMPLIANCE <br /> ;S THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: El NO El YES--See Below&Pg.2 <br /> ' 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 <br /> of this application(see next page),AND Plan Review is NOT required because I meet all of the following sub sections that do not <br /> See Page 2 require Plan Review. <br /> ARE YOU AN OWNER PERFORMING WORK AS THE CONTRACTOR WITHOUT ELECTRICAL LICENSURE: ENO DYES-See Below&Pg.3 <br /> Pursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease <br /> without the proper electrical licensing and certification, or exemption. By checking this box, I am stating that I have completed and <br /> See Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT BUSINESS NAME(If Commercial): Boeing <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 <br /> cin. Seattle STATE WA ZIP 98124-2207 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: General Construction Company <br /> CONTRACTOR ADDRESS: STREET PO Box 46 <br /> "� <br /> CITU Mukilteo STATE WA ZIP 98204 <br /> CONTRACTOR PHONE:425-294-6944 CONTRACTOR EMAIL:Bridgett.Burns@kiewit.com <br /> CONTRACTOR LIC.#(REQUIRED):GENERCC984OZ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):040599 <br /> PRIMARY CONTACT: DOWNER CONTRACTOR ❑OTHERPlease Specify) <br /> pecify) <br /> CONTACT NAME: CONTACT PHONE:206-730-6546 <br /> Dennis Crow CONTACT EMAIL:Dennis.crow@kiewit.com <br /> 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 <br /> 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 <br /> local law regulating construction or the performance of construction. That t am authorized by the owner of this properly to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> Q' rlAuthorize Agent Date (Revised 1/11/2018) Page 1-Application J <br />
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