1402 SE EVERETT MALL WAY FOOTLOCKER 2020-02-06

► ELECTRICAL PERMIT APPLICATION // CITY OF EVERETT PERMIT SERVICES P��' � 3200 CEDAR STREET.EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(El rwerect pstit'i-voretiwa,gov I vww.everettwa.govlpermiis 1a : PROJECT SITE INFORMATION. PROJECT ADDRESS: 1402 SE Everett Mall Way Space 375 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: Q COMMERCIAL ,,,,t3' 4 E .. ,, 4 1 _, i 110.0IoN;1 lF RMATIo . , ' ORIPT. :'<OF WOR.:.,!itlealiMAZ: 5:, CONTRACT PRICE OF WORK:$ 4900.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Retrofit 46 existing can lights with new LED Lamps, bypassing ballast. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO El YES-Select Scope:Cl Service ❑Feeder ❑ Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: t —� SELECT SCOPE(REQUIRED): El Data Data Intercom 0 Thermostat 0 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 All): ,��„ yN4,;, a,;. .n::,VOI. ,...:?. ,. s p ii,-§'TIZKA1^'' `�,`�'�lgFittgV * fi=r IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: i• NO I YES--See Below&Pg.2 _ 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: ONO OYES-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, rr` r s 1 rtt CONT ,;•, 'MATIOC `4> , OWNER NAME: Brixton Capital TENANT BUSINESS NAME(If Commercial):Footlocker OWNER MAILING ADDRESS: smsc- 120 S Sierra Ave , Solana Beach srATEn CA ZIP 92075 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Northwest Edison CONTRACTOR ADDRESS: STr.::.u.•11807 North Creek Pkwy South Suite B-103 cry Bothell i,, WA ;F,a 96011 CONTRACTOR PHONE:4258069200 CONTRACTOR EMAIL:joanb nwedison.cOm CONTRACTOR LIC.#(REQUIRED):NORTHEI983RD CITY OF EVERETT BUSINESS LIC.#(REQUIRED):050699 PRIMARY CONTACT: ❑OWNER 1CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425_892-11 10 Joan Blacker CONTACT EMAIL:joanbt@nwedison.com AGREEMENT'I hereby certify that t have read and examined this application and know the same to be Inns and correct. AO-provisions of laws and ordinances governing this type of work wilt be completed whether specified herein or not. The granting of a patina does not presume to give authority to violate or cancel the provisions of any other state or local few regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and l comply with the State Cent _ors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: i- 0 F.,-� /- t: mai5er! w, .r «fir Coate ( evised ++�� 1/17/2019,) Page{-Application a