3003 W CASINO RD BLDG 40-25 2023-12-15

�talzs �9bY 00$ (371py� '�.ECTRICAL PERMIT APPL CATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 4re7T (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.govlpermits 17 N—, PROJECT SITE'INFORMATION PROJECTADDRESS:,)D3 fit) f r,Q 1C.(Jt &{ Vt114- BUILDING AREA: 1O"( � L s4411 PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE El DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: El COMMERCIAL ELECTRICAL:APPLICATION'INFORMATION 8.'DESCRiPTION OF WORK CONTRACT PRICE OF WORK:$ ,e; l OOP ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: -,toc,k_le-+ + s ea tOO l w ip - eed€rs THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL,THAT APPLY) LiNE VOLTAGE WORK? ❑ NO 'ES-Select Scope: ❑Service Uv Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? iO ❑YES-#of Devices: • SELECT SCOPE(REQUIRED): El Data El Intercom ❑Thermostat Cl Audio El Secure Access El 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. El Other(List All): CODE COMPLIANCE THIS PERMIT EDUCATION,INSTITUTIONAL,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: (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. CONTACT iINFORMATION OWNER NAME: TENANT BUSINESS NAME(If Commercial): Boeing OWNER MAILING ADDRESS: STREET PO Box 3707 CITY Seattle STATE v v tom! A zip 98124-2207 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: General Construction Company rCONTRACTOR ADDRESS: STREET PO Box 46 CITY Mukilteo STATE WA zip 98204 CONTRACTOR PHONE:425-294-6944 CONTRACTOR EMAIL:Bridgett.Burns@kiewit.com CONTRACTOR LIC.#(REQUIRED):GENERCC984OZ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 040599 PRIMARY CONTACT: [DOWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-730-6546 Dennis Crow CONTACT EMAIL:Dennis.crow@kiewit.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 l 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 Uee Only PERMIT#: .� - ,� Zl-1 E 0 5-- I (2`Z e•, . /Aufho zed Agent ignature Date (Revised 1/11/2019) Pagel-Application