3003 W CASINO RD BLDG 40-27 2019-07-12

cLECTRICAL PERMIT APPLILIATION CITY OF EVERETT PERMIT SERVICES /—; 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwagov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3003 West Casino Road, Everett WA BUILDING AREA: 40-27 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ✓❑ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 9,680.20 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF WORK: Disconnect and receptacle install. , 6 ,t-,---;. e z 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: 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): 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 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: The Boeing Company TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3003 West Casino Road CITY Everett STATE WA ZIP 98204 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: VECA Electric&Technologies CONTRACTOR ADDRESS: STREET 5614 7th Ave S cm, Seattle STATE WA ZIP 98108 CONTRACTOR PHONE:206-436-5200 CONTRACTOR EMAIL:david.wolf@veca.com. CONTRACTOR LIC.#(REQUIRED):VECAED1542MU CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 004945 PRIMARY CONTACT: DOWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-683-3469 Orville Sieffert CONTACT EMAIL:Orville.Sieffert@veca.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 I comply with.tfie State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only (- / J PERMIT#: (1.-- --e_W - ' 3-.21- 15 E no-3 _ , 39 Owner/Authorized Agent Signature Date (Revised 1/11/2019) Page 1-Application