1130 SE EVERETT MALL WAY BEST BUY 2020-02-06

i. ELECTRICAL PERMIT APPLItON EVERETT 32CITY OF EVERETT PERMIT SERVICES 00 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX425-257-8857 I(E)everetteps@everettwa.gov I vnvw.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1130 Se Everett Mall Way BUILDING AREA: sq ft PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION EE TENANT IMPROVMENT El REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑DUPLEX 0 ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRiCE OF WORK:$ 1,105 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install new MC from ceiling junction box through fixture extension at display fixture. Install 1 duplex controlled EMS contractor and 1 duplex unswitched. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LiNE VOLTAGE WORK? EO NO El YES-Select Scope:❑Service El Feeder El Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? E❑NO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data El Intercom El Thermostat El 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 Alp:Electrical CODE COMPLIANCE IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ENO 0 YES—See Below&Pg.2 C 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 flPursuant to RCW 19.28.261,property owners and leaseholders cannot perform electrical work on buildings for rent,sale,or lease 1 I 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: Best Buy TENANT BUSINESS NAME(If Commercial):Best Buy OWNER MAILING ADDRESS: s aEer 7601 Penn Ave. S cm, Richfield STATE MN ZIP 55423 OWNER PHONE: 612-291-1000 OWNER EMAIL: CONTRACTOR NAME: Lin R. Rogers Electrical Contractors Inc. CONTRACTOR ADDRESS: STHCET 2050 Marconi Drive, Ste. 100 cm, Alpharetta sTATE GA zip 30005 CONTRACTOR PHONE:770-772-3473 CONTRACTOR EMAIL: License@LRogersElectric,com CONTRACTOR LiC.#(REQUIRED): LINRRRR956B1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):51310 PRIMARY CONTACT: DOWNER ❑E CONTRACTOR DOTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 770-772-5505 Amanda Lee CONTACT EMAIL: License@LRogersElectric.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 1 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#: Owner/Auth zed Agent Iature Date (Revised 1/11/2019) Page 1•Application