11014 19TH AVE SE BIMS LAUNDRY CAFE 2021-02-26

ECTRICAL PERMIT APPLIL TION Olen- 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 PROJECT ADDRESS: 1 1014 19th Ave SE, Suite 19A BUILDING AREA: 1,488 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT El REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑ DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 5,642 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Installing & Connecting 1 Illuminated Channel Letter Signs mounted on a raceway to existing 20 amp dedicated circuit THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑✓ NO ❑YES-#of Devices: 1 SELECT SCOPE(REQUIRED): ❑ Data El Intercom ❑ Thermostat ❑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. Channel Letter Signs mounted on a raceway 7 Other(List All): CODEZ OMPLIANcE IS THIS PERMIT EDUCATION, INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO El 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 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: SKOTDAL BROTHERS LLC TENANT BUSINESS NAME(If Commercial): Bims Laundry Cafe OWNER MAILING ADDRESS: STREET 2707 COLBY AVE#1200 CITY Everett STATE WA zip 98201 OWNER PHONE:David Graef 425 252 5400 OWNER EMAIL: Dave.Graef@skotdal.com CONTRACTOR NAME: BB &T SIGN SERVICES CONTRACTOR ADDRESS: STREET 16212 BOTHELL EVERETT HWY, STE F239 ciTv MILL CREEK STATE WA ZIP 98012 CONTRACTOR PHONE: 425.330.8160 CONTRACTOR EMAIL:bbtsigns@msn.com CONTRACTOR LIC.#(REQUIRED): BBTSIS`990PQ EXP.3/9/2022 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER ZCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425.330.8160 Frank Gonzales CONTACT EMAIL: bbtsigns©msn.com AGREEMENT:I hereby certify that/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#: � f)�b E 2 002' 0�( / Owner/Authorized Agent Signature Date (Revised 1/11/2019) ` Page 1-Application) s