10200 19TH AVE SE COSTCO HEARING CENTER 2022-01-21

ELECTRICALtERMIT & FIRE ALARM PAMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits OSIETT PROJECT SITE INFORMATION PROJECT ADDRESS:10200 19th Ave SE PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ❑✓ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL BUILDING AREA: 1000 sq ft Hearing Center ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$2,600.00 ASSOCIATED BUILDING PERMIT#(if applicable): IS THIS LOW VOLTAGE WORK? ❑✓ NO ❑ YES-#OF DEVICES: IS THIS A FIRE ALARM PERMIT? ❑✓ NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK & CODE COMPLIANCE DESCRIPTION OF WORK: Relocate (2) existing hearing booth receptacles, reconfigure existing case work as required. Rolocate existing LED light fixtures, add (2) new 20A 120V branch circuit and receptacles for new hearing booth. IS THIS PERMIT EDUCATION,INSITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ❑✓ 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 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 signed the See Page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/certification requirement. CONTACT INFORMATION OWNER NAME: Costco Wholesale TENANT BUSINESS NAME(If Commercial): • OWNER:MAILING ADDRESS: STREE 999 Lake Drive ci y Issaquah STATE WA ZIP 98027 OWNER PHONE:424-313-8000 OWNER EMAIL: CONTRACTOR NAME:Trig Electric Service, Inc. CONTRACTOR ADDRESS: STREET 1 121 Rainier Ave S aTv Seattle STATE WA zip 98144 CONTRACTOR PHONE:206-328-0555 CONTRACTOR EMAIL:)mullinS@trigelectric.com CONTRACTOR LIC.#(REQUIRED):TRIGES1054R1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 16392 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Mullins CONTACT PHONE:206-328-0555 Jeffrey CONTACT EMAIL:jmullinS@trigeleCtriC.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# / 0(1 ' - 2_ /)/, 09/25/2019 wn utho ed Age t Signature - Date (Revised 11/5/2018) Page 1-Application