3003 W CASINO RD BLDG 40-22 2020-11-24

II I ELECTRICAL PERMIT APPLICATION 4rErr CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION li "t PROJECT ADDRESS: 3003 West Casino Road, Everett,WA 98203 BUILDING AREA:Building 40-22 E9 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑X COMMERCIAL � 'RIC , PPLA *l. INFORMATION&.toeSCRIPTINOF WORK CONTRACT PRICE OF WORK:$ $5,500.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: 219162-Install two quadplex outlets. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑1 NO [YES-Select Scope: CI Service CI Feeder 7Circuits-#: 2 CI Complete Re-wire n I LOW VOLTAGE WORK? NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio El Secure Access ❑ Security System ❑ 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: X❑ NO El YES--See Below&Pg. 2 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 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: ❑X NO EYES-See Below&Pg.3 X 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. CONTACT INFORMATION OWNER NAME: Boeing Company TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET PO Box 3707 MS 1 F 09 clm' Seattle STATE WA ZIP 98124 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Foy Group CONTRACTOR ADDRESS: STREET 901 Powell Ave SW Suite 100 CITY Renton STATE WA ZIP 98057 CONTRACTOR PHONE: 206.937.6150 CONTRACTOR EMAIL: cory.s@foygroup.net CONTRACTOR LIC.#(REQUIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044569 PRIMARY CONTACT: DOWNER X❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Cory Simpson CONTACT PHONE: 425.283.9515 CONTACT EMAIL: cory.s@foygroup.net 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 goveming 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 I 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#: 6/27/2019 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application