3003 W CASINO RD BLDG 40-34 2019-07-12

ELECTRICAL PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3003 WEST CASINO ROAD 1(Q CM-t'13tIJEING AREA: 100K sq ft PROJECT TYPE: ❑ NEW CONSTRUCT ADDITION ElTENANT IMPROVMENT ElREMODEL BUILDING USE: CI SFR 1] rA NHOUSE {❑ DUPLEX ❑ADU ❑ MULTI FAMILY #OF UNITS: ❑✓ COMMERCIAL ELECT 7,0 AL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WOR •,'$ 13,000 ,d' ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIBE SCOPE OF We RK: REPLACE TYCO SP-INKLER,1ONITORING PANEL. THIS INSTALLATION INCLUDES THE FJ •OWING ( EC' ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ! IIIA YES-Seect Ser ce ❑ Feeder ❑ Circuits-#: ❑ Complete Re-wire LOW VOLTAGE WORK? ❑ NO / ❑✓ YES-# .f Device::52 SELECT SCOPE(REQUIRED): ❑ Dat:, ❑ In --rcom II The ostat ❑Audio ❑ Secure Access ❑ Security System ❑✓ Fire A = -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: BOEING TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3003 WEST CASINO ROAD 40-34 BLDG. COLUMN K-13.5 CITY EVERETT STATE WA ZIP 98203 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ALEXANDER GOW FIRE EQUIPMENT CO. CONTRACTOR ADDRESS: STREET 1436 NW 53RD STREET CITY SEATTLE STATE WA ZIP 98107 CONTRACTOR PHONE:206-632-2810 CONTRACTOR EMAIL:kmullen@gowfire.com CONTRACTOR LIC.#(REQUIRED):ALEXAGF097NW CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 050029 PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-718-1009 KEVIN M U L L E N CONTACT EMAIL:kmullen@gowfire.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 ontractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only •CI , PERMIT#: 2,)1 E -2-V40 O ,117p•uthorized Agent Signature Date (Revised 1/11/2019) Page 1-Application