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3003 W CASINO RD BLDG 40-02 2020-11-24
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3003 W CASINO RD BLDG 40-02 2020-11-24
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Last modified
11/24/2020 11:20:37 AM
Creation date
11/24/2020 11:20:34 AM
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Address Document
Street Name
W CASINO RD
Street Number
3003
Tenant Name
BLDG 40-02
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tiPECTRICAL PERMIT APPLISTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> Imo' x - 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: 3003 West Casino Road,Everett,WA 98203 BUILDING AREA:Building 40-02 B7-12/E7-12 sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION El ADDITION 0 TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: ❑X COMMERCIAL <br /> CONTRACT PRICE OF WORK:$ $29,000.00 ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIBE SCOPE OF WORK: 219254-40-02 Add 480v Outlets.add(4)30a disconnects&cord receptacles.Add(4)additional 30a cord hung <br /> recep aces o exls ing c s. 'el)ace : exis mg p •rea ers w new. <br /> THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) <br /> LINE VOLTAGE WORK? ❑ NO ❑X YES-Select Scope: ❑Service 0 Feeder 0 Circuits-#: 8 ❑Complete Re-wire <br /> LOW VOLTAGE WORK? 0 NO El YES-#of Devices: <br /> SELECT SCOPE(REQUIRED): ❑Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑Security System <br /> ❑ 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 /> IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: © NO • YES--See Below&Pg.2 <br /> X 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: M NO AYES-See Below&Pg.3 <br /> EPursuant 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 /> i <br /> OWNER NAME: Boeing Company TENANT BUSINESS NAME If Commercial : <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 MS 1 F 09 <br /> ci,- Seattle STATE WA ZIP 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Foy Group <br /> CONTRACTOR ADDRESS: STREET 901 Powell Ave SW Suite 100 <br /> mIn, Renton STATE WA ZIP 98057 <br /> CONTRACTOR PHONE: 206.937.6150 CONTRACTOR EMAIL: cory.s@foygroup.net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044569 <br /> PRIMARY CONTACT: ID OWNER XICONTRACTOR BOTHER(Please Specify) <br /> CONTACT NAME: Cory Simpson CONTACT PHONE: 425.283.9515 <br /> CONTACT EMAIL: cory.s@foygroup.net <br /> 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 <br /> 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 <br /> local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only <br /> PERMIT#: <br /> 10/30/2019 E l I I QO <br /> Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application <br />
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