7725 EVERGREEN WAY BIG BOX OUTLET STORES 2023-04-04

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 WASHINGTON (P) 425-257-8810 1 (E) PermitServices@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:7725 Evergreen way H001 BUILDING AREA: 22800 sq ft PROJECT TYPE: [I NEW CONSTRUCTION []ADDITION 2]TENANT IMPROVMENT []REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE [:]DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: 0 COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $24000 ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIBE SCOPE OF WORK: Install wall channel letter sign LED low voltage to existing sign cercuit Install wall channel letter sign LED low voltage to existing sign cercuit THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 2 NO [I YES - Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re -wire LOW VOLTAGE WORK? ❑ NO 0 YES- # of Devices.4 12 volt drivers SELECT SCOPE (REQUIRED): ❑ 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 All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: Lj NO LJ YES -- See Below & Pg. 2 ❑ By checking this box, I am stating that 1 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: FINO ❑YES -See Below & Pg. ❑ 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 NAMERegency Centers Corp TENANT BUSINESS NAME (If Commercial): Big BOX Outlet OWNER MAILING ADDRESS: STREET 10900 NE 4th Street suite 2230 c,T.r Bellevue STATE WA Z,P98004 OWNER PHONE:4256772267 1OWNER EMAIL:danieltuccillo@regencycenters.com CONTRACTOR NAME: Mike Neon Signs CONTRACTOR ADDRESS: STREIT2216 100th St SE CITY Everett STATE WA Z,P98208 CONTRACTOR PHONE:4257500824 1 CONTRACTOR EMAIL: evercole@aol.com CONTRACTOR LIC. #(REQUIRED):mikesns033cr CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 35347 PRIMARY CONTACT: [-]OWNER ❑CONTRACTOR [D OTHER (Please Specify) Adjent CONTACT NAME: Eric St i e m e rt CONTACT PHONE:2068415175 CONTACT EMAIL: eric@deksignco.com AGREEMENT. 1 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 Onl PERMIT #: ,� � 2/8/2023 JE Owner/Authorized Agent Signature Date (Revised 41512022) Page 1-Application