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OLT E :CTRICAL PERMIT API !CATION <br /> 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 www.everettwa.gov/permits <br /> (q +fit Aye SC," . c{`, F,..i. PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: Silver Lake ES - 12815 Bothell Everett Hwy, Everett, WA 98208 <br /> BUILDING AREA(if residential, new construction, remodel,or addition)100 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: la COMMERCIAL <br /> USE OF BUILDING: Education <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 7500 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Addition of electrical branch circuits to support telecommunication equipment. <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett Public Schools TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> cin, Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-386-4194 OWNER EMAIL: MHPierce@everettsd.org <br /> CONTRACTOR NAME: TBD - Public Bid <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 2 OTHER(Please Specify) Electrical Engineer <br /> CONTACT NAME: CONTACT PHONE: 206-859-5396 <br /> Jeff Hoover, PE - Hargis Engineers CONTACT EMAIL:jeff.hoover@hargis.biz <br /> 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 <br /> 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 <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 /> i <br /> City of Everett Official Use Only <br /> (/72 PERMIT# <br /> ,� /�7 s _ <br /> f ,/ /� -",./A { 5/8/2018 E `'gd l`7 <br /> Ow f <br /> er/Authorized Agent Signature Date (Revised 9/23/2016) <br /> 6.D... <br />