3003 W CASINO RD BLDG 45-05 2023-06-26

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT3200 CEDAR STREET, EVERETT. WA 98201 (P)425-257-8810 1 (E) Permit Services@everettwa.gov I www everettwa.gov/permits WASHINGTON PROJECT SITE INFORMATION PROJECT ADDRESS:3003 West Casino Rad Everett,WA 98204 BUILDING AREA: 1000 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE [] DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL ELECTRICAL APPLICATION INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $120,000 ASSOCIATED BUILDING PERMIT#(if applicable):N/A DESCRIBE SCOPE OF WORK: Provide distribution panel power for(4) trailers. Install conduit for data fiber. Install receptacles and heat trace for trailers. Seq. Job#202657 THIS INSTALLATION INCLUDES THE FOLLOWING SCOPE: (SELECT ALL THAT APPLY) LINE VOLTAGE WORK? ❑ NO ❑✓ YES-Select Scope: 0 Service ✓❑Feeder ❑✓ Circuits-#:5 ❑Complete Re-wire LOW VOLTAGE WORK? ❑ NO 0 YES-#of Devices:40 SELECT SCOPE(REQUIRED): 0 Data ❑Intercom ❑Thermostat ❑Audio ❑Secure Access In 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: 21 NO LJ YES—See Below& Pg. 2 F-1By 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 ❑YES-See Below&Pg. ❑ 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): The Boeing Company OWNER MAILING ADDRESS: STREET PO Box 3707 c,T., Seattle STATE WA Z,P 98184 OWNER PHONE:206.766.2907 OWNER EMAIL:angela.hocking@sequoyah.com CONTRACTOR NAME:Sequoyah Electric LLC CONTRACTOR ADDRESS: STRE115135 NE 92nd Street Redmond STATE WA Z,P98052 CONTRACTOR PHONE:425.814.6000 1CONTRACTOR EMAIL:angela.hocking@Sequoyah.Com CONTRACTOR LIC.#(REQUIRED):SEQUOEL977S9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):40645 PRIMARY CONTACT: ❑OWNER EICONTRACTOR E]OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.766.1875 Tom Sager CONTACT EMAIL:tom.Sager@Sequoyah.COm AGREEMENT.I hereby certify that 1 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/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: 4.7. 2,3 E Owner/ orized Age Signature Date (Revised 4/5/2022) Page 1-Application