221 SE EVERETT MALL WAY RED WING SHOES 2020-02-06

E CTRICAL PERMIT APPL'n NTION EVERETT CITY OF EVERETT PERMIT SERVICE 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov i www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 221 SE Everett Mall Way BUILDING AREA: sq ft PROJECT TYPE: LI 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: $ 3,000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Remove defective meter base and install new meter base THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: 0 Service ✓❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ,❑ NO ❑ YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑Audio ❑ 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): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑YES--See Below&Pg.2 1 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: ❑✓ NO 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: Shilla, INC C/O: MK Properties TENANT BUSINESS NAME(If Commercial): Red Wing Shoes OWNER MAILING ADDRESS: STREET PO BOX 997 CITY Snoqualmie STATE WA ZIP 98065 OWNER PHONE:425-888-2993 OWNER EMAIL:syd@mkps.net CONTRACTOR NAME: Tandem Electric (d/1,41 / `(j(Ci (J Yl CONTRACTOR ADDRESS: STREET13708 24th St E #B-102 / CITY Sumner STATE WA ZIP 98390 CONTRACTOR PHONE:253--395-8806 CONTRACTOR EMAIL:Info@tandemelectric.COm CONTRACTOR LIC.#(REQUIRED):JWRELEI834LW CITY OF EVERETT BUSINESS LIC.#(REQUIRED):60185 PRIMARY CONTACT: El OWNER ❑CONTRACTOR ['OTHER(Please Specify) Project Manager CONTACT NAME: CONTACT PHONE:253-202-51 69 Keith Lynn CONTACT EMAIL:keith@tandemelectric.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 Late 18.27 RCW and 296.200 WAC. City of Everett Official Use Only ri/ rr r PERMIT#: 1'; EGIDt, i'bwnerlAuthorozdd Agg'nt Signature Date (Revised 1/11/2019) Page 1-Application