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0411. ELECTRICAL PERMIT APPLICATION <br /> vill .7 4 I CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 I(E)everetteps@everettwa.gov I wymeverettwagovipennits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3927 Rucker Ave <br /> BUILDING AREA(if residential,new construction,remodel,or addition)1,046 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 21 COMMERCIAL <br /> USE OF BUILDING: Commercial <br /> (: ELEC4RICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 8 i,603.94 <br /> NUMBER OF DEVICES(if low volt e);.48 <br /> FIRE ALARM? DYES 0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION:.OF WORK: The Everett Clinic-Gunderson Building-Walk-in Clinic TI.. Installation of Cat5e voice <br /> /data cabling and re-installation of(3)overhead paging speakers with(2)volume controls. <br /> CONTACT INFORMATION <br /> OWNER NAME: Healthcare Partners RE LLC TENANT NAME(If Commercial):The Everett Clinic <br /> OWNER MAILING ADDRESS: STREET 3901 Hoyt Ave <br /> oir( Everett STATE WA. zip 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Structured Communications <br /> CONTRACTOR ADDRESS: STREET PO Box 1366 <br /> cm.Snohomish STATE VVA ZIP 9 <br /> CONTRACTOR PHONE: 425-321-5343 CONTRACTOR EMAIL: dustin,duke@gostructured.com <br /> CONTRACTOR LIC.#(REOL/IRED): STRUCC*8920L CITY OF EVERETT BUSINESS LIC.#(REQUIR DI: 050586 <br /> . <br /> PRIMARY CONTACT: DOWNER. 12)CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NE: CONTACT PHONE: 425-367-3977 <br /> David Meyer CONTACT EMAIL:david.meyer©gostructured.com <br /> AGREEMENT:I hereby cerffly that I have read and examined this application and know the same to be true ald COrreCL, Al/provisions Of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The granting of a pennit does not presume to give authority to violate or cancel the provisions of any otherstate or <br /> 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 <br /> comply with the State Contractors Law 18,27 RCW and 296,200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> r i <br /> ey , A i E SO6 - 99 <br /> , mp P CV/12110(g <br /> o riA - zed Agent . • Dote (Revised 9/23'2016) <br />