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1130 SE EVERETT MALL WAY PETSMART 2020-02-06
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1130 SE EVERETT MALL WAY PETSMART 2020-02-06
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2/6/2020 3:26:34 PM
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2/6/2020 3:26:24 PM
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Address Document
Street Name
SE EVERETT MALL WAY
Street Number
1130
Tenant Name
PETSMART
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liz ELECTRICAL PERMIT APPLIUATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1 130 SE Everett Mall Way BUILDING AREA: 5000 sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL <br /> ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ 5,841.80 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: <br /> We are replacing 55 existing highbay fixtures with new LED fixtures and 3- 8' strip fixtures with new led <br /> fixtures. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#:5 ❑Complete Re-wire <br /> LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ Thermostat ❑Audio ❑ 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 /> El Other(List All): <br /> CODE COMPLIANCE <br /> IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ NO ❑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 EYES-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): PETSMART <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Northwest Edison <br /> CONTRACTOR ADDRESS: STREET 11807 North Creek Parkway South Suite B-103 <br /> CITY Bothell STATE WA ZIP 98011 <br /> CONTRACTOR PHONE:425-806-9200 CONTRACTOR EMAIL:Oler©nWediSon.COm <br /> CONTRACTOR LIC.#(REQUIRED):NORTHEI983RD CITY OF EVERETT BUSINESS LIC.#(REQUIRED):50699 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-354-0610 <br /> Ole Rodne CONTACT EMAIL:oler@nwedison.com <br /> AGREEM. T.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 we 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 lacy gulating 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 <br /> com h the State Contractors Law 18.27 RCW and 296.200 WAC./ __,_-__-- 6/21/19 City of Everett Official Use Only <br /> PERMIT#: <br /> E .0 — I � <br /> " <br /> Owne Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />
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