7400 HARDESON RD SUNBELT RENTALS 2021-09-24

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX42"5'-y2557{-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 7400 Hardeson Rd BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ✓❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OFF UNITS: y - ❑✓ COMMERCIAL t 9 A A '� .- _ . CONTRACT PRICE OF WORK:$ 300 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install one internally illuminated wall sign on the tenant's east exterior elevation. Will use existing sign circuit. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑YES-Select Scope: ❑ Service ❑ Feeder El Circuits-#: El Complete Re-wire LOW VOLTAGE WORK? ❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑Thermostat El 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):sign install to existing circuit IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: El NO II 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: 1: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. OWNER NAME: ZAMBERLIN GEORGE S BYPPa TENANT BUSINESS NAME(If Commercial): Sunbelt Rentals OWNER MAILING ADDRESS: STREET 519 N 66TH ST CITY Seattle STATE WA zip 98103 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Culbertson Sign Service CONTRACTOR ADDRESS: STREET 5209 122nd St E CITY Tacoma STATE WA zip 98446 CONTRACTOR PHONE:253-538-0752 CONTRACTOR EMAIL:csspermits@gmail.com CONTRACTOR LIC.#(REQUIRED):CULBESS984MU CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 053695 PRIMARY CONTACT: ['OWNER ['CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-538-0752 Hans Visser CONTACT EMAIL:csspermits@gmail.com 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#:I k &/ 06/21/2021 E 2 ` 0 G- sn Owner Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application