3003 W CASINO RD BLDG 40-04 2020-12-30

ACTRICAL PERMIT APPLIATION 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 WWI.everettwagov/permits grwr PROJECT ADDRESS: 3003 W Casino Road Bid 40-04 ri\) 2are-BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION O ADDITION ❑TENANT IMPROVMENT ElREMODEL BUILDING USE: ❑SFR WIkSE4)UPLEX ❑ADU ElMULTI FAMILY #OF UNITS ❑COMMERCIAL EL C . . .,.A. APP IION IN !." *141 , cRiP IoN or. v ,. CONTRACT PRICE OF WO :$ ; (j) 0470,, Ud/ 'ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE 0 WORK: Install new control or C ' g Tower THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO In YES-SplartScppe: ❑ Service El Feeder CI Circuits-#: CI Complete Re-wire LOW VOLTAGE WORK? NO ❑✓ YEI#of Devices:`70` SELECT SCOPE(REQUIR D). ❑ Data ❑ I oma-_. T'ierrriagfaf LJ 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. ✓❑Other(List All):HVAC controls tigii IS HIS�PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/ORPLC 9 PERSONAL CARE FACILITIES: ✓❑ NO in 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: ✓❑NO 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. �......... .\��.�, ...0OItITACrT INP �� .,,;. :.. .ram: ilMN7 OWNER NAME: Boeing Airplane Group TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET PO Box 3707 MS 1 F09 CITY Chicago STATE III. ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Foy Group CONTRACTOR ADDRESS: sTREET2400 NW 80th Street,Ste 118 CITY Seattle .STATE wa ZIP 98057 CONTRACTOR PHONE:206 743 2444 'CONTRACTOR EMAIL:wylie.h@foygroup.net CONTRACTOR LIC #(REQUIRED):FOYGRGC863LK CITY OF EVERETT BUSINESS LIC #(REQUIRED) 044569 PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-743-2444 WyI i e Hubbard CONTACT EMAIL:wylie.h@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 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#: -. �.: - E n0q - % 4.. Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application