1010 SE EVERETT MALL WAY AMERICAN RED CROSS 2025-03-25

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: 1010 SE Everett Mall Way BUILDING AREA: 25.5 sq ft PROJECT TYPE: °❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT []REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL ELECTRICAL APPLICATION INFORMATION 8r, DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $12000 ASSOCIATED BUILDING PERMIT#(if applicable):S2304-005 DESCRIBE SCOPE OF WORK: Installing illuminated channel letter sign to building exterior using existing wiring. Installing illuminated channel letter sign to building exterior using existing wiring. THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ✓❑ NO DYES-Select Scope:❑Service ❑Feeder ❑Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO El YES-#of Devices:One LED line 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):Signage CODE COMPLIANCE IS THIS PERMIT EDUCATION, INSTITUTIONAL, HEALTH AND/OR PERSONAL CARE FACILITIES: Lj NO L!Lj YES--See Below&Pg.2 By checking this box, I am stating that I have read and understand all of WAC 296-46113-900,selected the specific reason on page El 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 ❑YES-See Below&Pg. E] 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:CPMNW TENANT BUSINESS NAME(If Commercial):American Red Cross OWNER MAILING ADDRESS: STREET 1509 Bonneville Ave Ste A CITY Snohomish STATE WA ZIP 98290 OWNER PHONE:4255180529 OWNER EMAIL:miazeolla@cpmnw.com CONTRACTOR NAME:Clearway Signs CONTRACTOR ADDRESS: STREET9426 Canyon Rd E ,,, Puyallup STATE WA 1,98371 CONTRACTOR PHONE:2532437777 CONTRACTOR EMAIL:darrin.jones@pugetsoundsigns.com CONTRACTOR LIC.#(REQUIRED):CLEARS'9271_7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 601 848 813 PRIMARY CONTACT: ❑OWNER OCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:2539813454 Da rri n Jones CONTACT EMAIL:darrin.jones@pugetsoundsigns.com AGREEMENT:I hereby certify that/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 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only #: Digit Darrin Jones Dateal 0sned23.0626y14:264100700' 6/26/23 EE Owner/Authorized Agent Signature Date (Revised 41512022) Page 1-Application