2803 COLBY AVE BOTAN RAMEN N BAR 2022-01-27

® ELECTRICAL PERMIT APPLICATION' CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASH ING TON (P) 425-257-8810 1 FAX 425257-8857 1 (E) everetteps@everettva.gov I %vtAv.evereM1,a. govipermits PROJECT SITE �21�FORMATION PROJECT ADDRESS: 2803 COIb Ave BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION [�I TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOVVNHOUSE El DUPLE: ❑ ADU ❑ MULTI FAMILY- # OF UNITS_ �° CO�rIiv1ERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 85 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: install 1 LED wall si n dis la THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? [11�1 NO ❑ YES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re -wire LOW VOLTAGE WORK? ❑---qq NO ❑✓I YES- # of Devices: 1 SELECT SCOPE (REQUIRED): D Data ❑Intercom Thermostat [IAudio ❑ 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): Sign CODE GOhNiFLIANCE t IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: - NO ❑ YES — See Below & Pg. 2 Fvlo By checking this box, I am stating that I have read and understand all of WAC 296-1613-900, 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: CJNO I 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 Sce Page 3 signed the AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT' fi FOM�IAT C IOWNER NAME: SkOtd2l Family Investments LLC TENANT BUSINESS NAME (If Commercial)' Sotan Raljjjen nPBa OWNER MAILING ADDRESS: sTkEtT 2707 Colo Ave Ste 1200 F CITY Everett STa,-E VVA z,, 98201 k OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: BB&T Sign Services l 16212 Bothell -Everett Hwy F239 { CONTRACTOR ADDRESS: sTHetl 4 cITY MillCreek STATt VVA �;, 980`i2 ' rr�� CONTRACTOR PHONE:�^^25330816O CONTRACTOREMAIL:bbtSI nS msn.Crom CONTRACTOR LIC. #(REQUIRED): BBTSIS*990PQ ICITY Or EVERETT BUSINESS LIC. #(REQUIRED): 055104 PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: FCONTACT ra PHONE: ` 25.330. 8160 CONTACT EMAIL: bbtSl ns msn.com �. ��• • a..y i' ,'Wy liar i rravc raao anu examined this apprrcauon and Know me saire 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 sloes not presume to give authority to violate or cancel the provisions of any other stale or local law regulating construction or the perfomrance of construction. That] am authorized by the otitinei of this property to pelforrn the work for which apolicatbn is mace and i comply with the State Contractors Law 18.27 RCW and 298.200 WAC. Citv of Everett Official Use Only PERMIT #. Owner/Authorized Ay fit SignatV e Date (Revised 1/11/2019) Page I Application