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

kirnerrEL4TRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERE I I,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1130 SE Everett Mall Way, Everett, WA 98208 BUILDING AREA: sq ft PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION D TENANT IMPROVMENT ❑REMODEL RI BUILDING USE: Li SFR E]TOWNHOUSE ❑DUPLEX ElADU ❑MULTI-FAMILY-#OF UNITS: RI COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ 9,753 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Lighting retrofit to existing interior fixtures with LED kits and Fluorescent highbay fixtures to LED. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope:El Service ❑Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑Data El Intercom ❑Thermostat ❑Audio ❑Secure Access ❑Security System ❑l 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: pi NO 17:1 YES—See Below&Pg.2 ❑ By checking this box,I am stating that I have read and understand all of WAC 296-4613-900,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/certiftcation requirement. CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial):Best Buy OWNER MAILING ADDRESS: STREET 1130 SE Everett Mall Way Ste A, y/' c,-y Everett STATE WA aP 98208 OWNER PHONE:(425) 355-9490 OWNER EMAIL: CONTRACTOR NAME: All Star Lighting DBA Lights Inc CONTRACTOR ADDRESS: sTREET3723 Serene Way CITY Lynnwood STATE WA ziP 98087 CONTRACTOR PHONE:2069493188 CONTRACTOR EMAIL:JSegura@lightsinc.com CONTRACTOR LIC.#(REQUIRED):LIGHTI*830R7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):59845 PRIMARY CONTACT: DOWNER DCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2069493188 Junior Segura CONTACT EMAIL:jsegura@lightsinc.com AGREEMENT:t 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 tam 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#: / ;)C--ICt EE �9O5 - �� Owner/ uthorized Agent Si azure Date (Revised 1/11/2019) Page 1-Application