10115 EVERGREEN WAY PEP BOYS 2024-04-02

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I(E)PermitServices@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:10115 EVERGREEN WAY BUILDING AREA: sq ft PROJECT TYPE: ❑✓ NEW CONSTRUCTION El ADDITION El TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX C ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$2000 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: INSTALL THREE SINGLE FACE ILLUMINATED WALL SIGNS AND ONE DOUBLE FACE ILLUMINATED UNDER CANOPY SIGN INSTALL THREE SINGLE FACE ILLUMINATED WALL SIGNS AND ONE DOUBLE FACE ILLUMINATED UNDER CANOPY SIGN THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) t� LINE VOLTAGE WORK? I NO EYES-Select Scope:❑Service ❑Feeder ❑Circuits-#. ❑Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): ri 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):SIGN CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: 0 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:QNO nYES-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 NAME:ROIC WASHINGTON LLC TENANT BUSINESS NAME(If Commercial): PEP BOYS OWNER MAILING ADDRESS: STREET 10115 EVERGREEN WAY CITY EVERETT STATE WA ZIP 98204 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:NATIOAL SIGN CORPORATION CONTRACTOR ADDRESS: STREET 1541 S 92ND PL CITY SEATTLE STATE WA Z,P 98108 CONTRACTOR PHONE:2062820700 CONTRACTOR EMAIL:STEVEZ©NATIONALSIGNCORP.COM CONTRACTOR LIC.#(REQUIRED):NATIOSC133MS CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2063802854 STEVE ZAMBERLIN CONTACT EMAIL:STEVEZ©NATIONALSIGNCORP.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 regulatin const ction 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 Sta Con actors Law 18.27 RCW and 296.200 WAC City of Everett Official Use Only PERMIT#: 6-7-27 E Z2C(o- 0.25 Owner/Auth riz /} nt Signature Date (Revised 4/5/2022) Page 1-Application