3003 W CASINO RD BLDG 40-22 2021-03-31

0:31 P CTRICAL PERMIT A P PLLCATION � k� / v4 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (4:Err (P)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa,gov I www.everettwa.gov/permits PROJECT SITE INFORMATION • PROJECT ADDRESS: �1b-22 k 1a t p ' BUILDING AREA: sq ft PROJECT TYPE: Li CONSTRUCTION ❑AD TION ❑TENANT IMPROVMENT El REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION 8 DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ �l f� � ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Cy c( .c - - YZ F% S r y-e_c eOrekLI1/4--e THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:NO (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? El NO El YES-Select Scope:YJ Service eder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? t�f ❑YES-#of Devices: SELECT SCOPE(REQUIRED): El Data LI Intercom El Thermostat El Audio ❑ Secure Access ❑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. ❑Other(List All): CODE COMPLIANCE IS,THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO ❑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: I_INO 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 cmr Seattle STATE WA zo, 9 81 24-22 07 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: General Construction Company CONTRACTOR ADDRESS: STREET PO Box 46 cirr Mukilteo STATE WA Z, 98204 CONTRACTOR PHONE:425-294-6944 CONTRACTOR EMAIL:Bridgett.Burns@kiewit.com CONTRACTOR LIC.#(REQUIRED):GENERCC984O2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 040599 PRIMARY CONTACT: DOWNER [CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-730.6546 • Dennis Crow CONTACT EMAIL:Dennis.crow@kiewit.com kiewit.com AGREEMENT:t hereby certify that l have reed 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 taw regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC. CCU of Everett Official Use Only PERMIT#: d 3 10-Itt-r1 `7\ ner/ thoriz gent Sig a ure Date (Revised 1/11/2019) Page 1-Application ^