1515 132ND ST SE 2022-01-20 - Laserfiche WebLink

in EVERETT WASHINGTON ILECTRICAL PERMIT + APPLICATION ,.MUj. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257.8867 l (E) everettepsgeverettwa.gov I www everettwa.00v/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1515 1 32nd Street SE Everett BUILDING AREA: 2600 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 . _11910-038 CONTRACT PRICE OF WORK: $ 10,000 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: Electrical Work for a remodel of existing multitenant building to a single tenant Jack in the Box restaurant building. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO Z YES - Select Scope: ❑ Service ❑ Feeder ❑✓ Circuits-M t2 ❑ Complete Re -wire LOW VOLTAGE WORK? ❑✓ NO ❑ YES- # of Devices: SELECT SCOPE (REQUIRED): F 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. ❑ Other (List Alt): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓ NO 71 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: PI NO YES -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: Tekln and Associates TENANT BUSINESS NAME if Commercial): Jack in the Box OWNER MAILING ADDRESS: STReeT 2600 North Dallas Parkway #370 ,r, Frisco STATE TX ZIP 75034 OWNER PHONE: 469.458.0485 OWNER EMAIL. Mark.Tekin@tekindevelopment.com CONTRACTOR NAME: To Be Determined CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑✓ OTHER (Please Specify) Auftnzed Agent CONTACT NAME: Glenna Mahar A r; RFFA,h-NT- 1 1,,,..r., 11— r 1....... CONTACT PHONE: 253.272,4214 CONTACT EMAIL: gmahar@sgravesassoc.com uPj' .c.,"„ __ ""' "" ""' to Uo ou C. anu cO"";'. "" provisions of Paws ann ordinances governing this type of weak 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/ am authofized 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 #: OwnerltAuthoriz Agent Signature Date (Revised 1/1112019) Page 1-Application