3003 W CASINO RD BLDG 40-25 2020-11-24

to2RZS", 2.`826c6,6-90 tLECTRICAL PERMIT APPLII,ATION ( 370C) CiTY OF EVERETT PERMIT SERVICES 44, 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 ': PROJECT ADDRESS:' Og 11' 00 5`1/16 Vti, _ jI- Wct BUILDING AREA: L/O-r '�t 4/7•5 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL " ELECTRICAL APPLICATION INFORMATION &`DESCRIPTION.OF WORK • CONTRACT PRICE OF WORK:$ 470 4000 [� ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: pi')l C, S 'L j(�'i � L�,� house Oo► i4ct cA-©rs / 2c cp4- Onvi4rr9 ) THIS INSTALLATION INCLUDES THE FOLLOyvING SCOPE: (SELECT ALL THAT APPLY) LiNE VOLTAGE WORK? ❑ NO g YES-Select Scope: El Serviceeeder ❑ Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? PrNO El YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat ❑Audio ❑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. 7 Other(List All): • CODE CO.MPLiANCE iS.THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El 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: ENO 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/certification requirement. CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial): Boeing OWNER MAILING ADDRESS: STREET PO Box 3707 CITY Seattle STATE WA zip 98124-2207 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: General Construction Company CONTRACTOR ADDRESS: STREET PO Box 46 CITY Mukilteo STATE WA ZIP 98204 CONTRACTOR PHONE:425-294-6944 CONTRACTOR EMAIL:Bridgett.Burns@klewit.com CONTRACTOR LIC.#(REQUIRED):GENERCC9840Z CITY OF EVERETT BUSINESS. LIC.#(REQUIRED): 040599 PRIMARY CONTACT: DOWNER ©CONTRACTOR ['OTHER(Please .(Pleaass.: ... ,_ ,. . ... . . e Specify) CONTACT NAME: CONTACT PHONE:206-730-6546 Dennis Crow CONTACT EMAIL:Dennis.crow@kiewit.com AGREEMENT'I hereby certify that I have read and examined this application and know the same to be true and correct. A//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 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#: avjrZI11 E1005- 1 �O•JfeilAuthorgent S ature ' Date (Revised 1/11/2019) Page 1-Application