315 SHUKSAN WAY 2024-06-12 - Laserfiche WebLink

• ECTRICAL PERMIT APPLPATION 477- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT.WA 98201 (P)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa.gov I wsw.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 315 Shuksan Way, Everett WA 98203 BUILDING AREA: 241,045 sq ft PROJECT TYPE: ❑✓ NEW CONSTRUCTION ❑ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑SFR ['TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 2,500 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Connecting Illuminated Channel Letters and Contoured logo sign to existing 20 amp dedicated circuit THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑✓ NO ❑YES-Select Scope: ❑ Service ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ✓❑ NO ❑ YES-#of Devices: 1 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):Channel Letter Signs mounted on a raceway CODE COMPLIANCE IS 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: ❑✓ NO EYES-See Below& Pg. 3 Pursuant to ROW 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: DPIF2 WA 7 MOUNTAIN VIEW TENANT BUSINESS NAME(If Commercial): AMAZON - DWS4 OWNER MAILING ADDRESS: STREET 11900 NE 1ST STREET, SUITE 300. CITY Bellevue STATE WA zrp 98005 OWNER PHONE:224-938-9647 OWNER EMAIL: Lberchicci@dermody.com CONTRACTOR NAME: Fastsigns Everett CONTRACTOR ADDRESS: STREET2802 Colby Ave CITY Everett STATE WA ZIc 98201 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):CCFASTS*`832JK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 056308 PRIMARY CONTACT: El OWNER ❑✓CONTRACTOR EOTHER(Please Specify) CONTACT NAME: CONTACT PHONE:OfC: 425.438.9350 ell: 360.572.7225 Duane ST E I G CONTACT EMAIL:Duane.Steig@Fastsigns.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 Il/V j2C2 t �� PERMIT#: • • % `` -/2oa1 E2�I11055- Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application