11627 AIRPORT RD BASE FILE 2020-12-28

► •LECTRICAL PERMIT APPLATION ��.-- CITY OF EVERETT PERMIT SERVICES '1'^' a .; 3200 CEDAR STREET,EVERETT,WA 98201 (P)425.257.8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov J www.everettwa.gov/perils - ,. r � ` PROJECTSITEINFORMATION N PROJECT ADDRESS: 11627 Airport Rd Everett,WA 98204 (BUILDING AREA:5,000 sq a PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT 0 REMODEL BUILDING USE: 0 SFR ❑TOWNHOUSE 13 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL ' r 3`'ELECTRICALAPPLICATIONINFORMATION8DESCRIP.TION-3OF<WORK \ti77 CONTRACT PRICE OF WORK:$ 8,597.00 ASSOCIATED BUILDING PERMIT#,(ii applicable): DESCRIBE SCOPE OF WORK: Replace 185 light fixtures THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE:(SELECT ALL THAT APPLY) LINE VOLTAGE WORK? 0 NO 0 YES-Select Scope:0 Service 0 Feeder 0 Circuits-#: ❑Complete Re-wire LOW VOLTAGE WORK? 0 NO ❑YES-#of Devices: SELECT SCOPE(REQUIRED): 0 Data ❑Intercom ❑Thermostat ❑Audio 0 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. ❑,r Other(List All):Replace existing fixtures \ • Ex , . LCODECOMPLIANCE �� ,.' f,�3. �:„rte_ ‘ ..... IS THIS PERMIT EDUCATION,INSTITUTIONAL,HEALTH AND/OR PERSONAL CARE FACILITIES: 0 NO ❑YES—See Below&Pg.2 0 By checking this box,I am stating that I have read and understand all of WAC 29646E-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 OYES-See Below&Pg3 I l 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 lensing 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 licensingfcertification requirement. 1,,; a CE, -arc CONTACT INFORMATION: �At4 7,717,v,-Amar:',,„; OWNER NAME: RH Airport Road, LLC TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 720 Seneca St. Suite B crry Seattle STATE WA zip 98101 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: West Coast Electrical Services CONTRACTOR ADDRESS: sTRErT12527 Mukilteo Speedway Suite 103 erre Lynnwood STATE WA by 98087 CONTRACTOR PHONE:425-322-3189 CONTRACTOR EMAIL: kyle Qt7WceleCtriCS.COm CONTRACTOR LIC.#(RQuIRED):1NESTCCE897PQ 'CITY OF EVERETT BUSINESS LIC.*REQUIRED):053544 PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-322-3189 Kyle Adams CONTACT EMAIL:kyle©wcelectrics 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 stale 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 Con dors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 10 I 143 E a�- I�Z OwnerlAI PERMITd Agent Signature (Revised 1/11/2019) Page 1-Application