10121 EVERGREEN WAY WHAT THE FLUFF 2021-11-02

OPECTRICAL PERMIT APPLITION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: "I0121 Evergreen Way BUILDING AREA: 243 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION I✓I TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: 7 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 4,000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Install lit channel letter sign over tenant's front door. 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 7 YES-#of Devices: SELECT SCOPE(REQUIRED): ❑ Data ❑ Intercom ❑ 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. 7 Other(ListAll): One channel letter sign. CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 7 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: NO ElYES-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: Cody Nilsson TENANT BUSINESS NAME(If Commercial): What The FluffDo�=i OWNER MAILING ADDRESS: STREET 14205 SE 36th Street ^J'IV,` ^ :m CITY Bellevue SLATE WA zip 98006 OWNER PHONE:425-990-6200 OWNER EMAIL:codypaadvisors.com CONTRACTOR NAME: M I KE'S NEON SIGNS CONTRACTOR ADDRESS: STREET 2216 100th ST SE CITY Everett STATE WA zip 98208 CONTRACTOR PHONE:425-750-0824 CONTRACTOR EMAIL:evercoleRaol.com 35 '341 CONTRACTOR LIC.#(REQUIRED):M I KESNSO33CR CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER ❑CONTRACTOR 7IOTHER(Please Specify) Crossroad SIGN (Sign contractor) CONTACT NAME: C.Th CONTACT PHONE:425-481 -941 1 J1„r �` CONTACT EMAIL: ryanccrossroadsign.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 Con ractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only /. '— PERMIT#: l E .Z1o3 - O7-5 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application