3003 W CASINO RD BLDG 40-58 2023-06-16

OTETT ACTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 3003 W Casino Rd, Everett WA 98204 BUILDING AREA: RI(in 4(1-.ciR f 7C-2 sq ft PROJECT TYPE: El NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS. ❑✓ COMMERCIAL 'E ....<.. A ,* CAT RTION _ OF CONTRACT PRICE OF WORK:$ 5.000.00 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: New install of maximum Sub layup head 100amp disconnect THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: El Service E Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED) ❑ Data ❑ Intercom ❑ Thermostat ❑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. El Other(List All): CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: ✓❑ NO ❑YES--See Below&Pg. 2 ✓ , I am stating I read and understand all of WAC -4 ,selected the specific reason on page 2 ofBy this applicationchecking thisbox(see next pagethat),ANDhave Plan Review is NOT required because296 I meet6B-900 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: ENO 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. COPEtiga, INFORMATION ‘,,17z �..... .:, OWNER NAME: Boeina Company - Everett TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Brad Liqer, Dunston Bradley Industrial Inc CONTRACTOR ADDRESS: STREET PO Box 13266 CITY Everett STATE WA ZIP 98206 CONTRACTOR PHONE:206-718-8823 CONTRACTOR EMAIL:Emily@dunstonbradley.com CONTRACTOR LIC.#(REQUIRED):fit JNRTRIQA14fl CITY OF EVERETT BUSINESS LIC.#(REQUIRED): (14Q149 R.Q.w.,... .•.,,. • ,. ,.,,,� ., PRIMARY CONTACT: ❑OWNER ❑✓CONTRACTOR EOTHER(Please Specify) CONTACT NAME: Brad CONTACT PHONE:206-718-8823 CONTACT EMAIL:Emily@dunstonbradley.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#: Fmilv I iner 1YV27/201 Q E Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application