10200 19TH AVE SE COSTCO FOOD COURT 2019-06-11

ELECTRICAL PERMIT & FIRE ALARM 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(ceverettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:10200 19th Avenue SE Everett,WA 98208 PROJECT TYPE: 0 NEW CONSTRUCTION ®ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: ®COMMERCIAL BUILDING AREA: 2400 sq ft ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$4500 ASSOCIATED BUILDING PERMIT II(if applicable): IS THIS LOW VOLTAGE WORK? 0 NO YES-it OF DEVICES:8 Cat5e data cables IS THIS A FIRE ALARM PERMIT? 0 NO ❑ YES-Plans required for review(Both Electrical and Fire Department inspections are required) DESCRIPTION OF WORK&CODE COMPLIANCE DESCRIPTION OF WORK: Instailina 8 cat5e data cayles.3 deditaed circuits(29 AMP)for one Panel.and 6 receptacles. IS THIS PERMIT EDUCATION,INSITUTIONAL,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 298465.900,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 UCENSURE:©NO OYES-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 signed the See page 3 AFFIDAVIT on page 3 of this application to receive an exemption from this licensing/cert0ication requirement. CONTACT INFORMATION OWNER NAME:COSTCO WHOLESALE CORP TENANT BUSINESS NAME(If Commercial): COSTCO OWNER MAILING ADDRESS: stREEr999 Lake Drive crry Issaquah STATE WA zip 98027 OWNER PHONE: IOWNER EMAIL: CONTRACTOR NAME:Wachter Inc. CONTRACTOR ADDRESS: STREET 16001 West 99th St. cry Lenexa STATE KS zrr+ 86219 CONTRACTOR PHONE:913-227-3911 (CONTRACTOR EMAIL:permitrequest©wachter.com CONTRACTOR LIC.*REQUIRED):EC WACHTI*904KL JCITY OF EVERETT BUSINESS LIC.#(REQUIRED): 043582 PRIMARY CONTACT: ❑OWNER ©CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:913-227-3911 Samantha Thomas CONTACT EMAIL:permitrequest@wachter.com AGREEMENT:t hereby certify that I have read and examined this application and know the same to be two 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 lam 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# 221 l 9 0 -- k i Owner/Authorized Signature Date (Revised 11/52018) Page 1-Application