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41677- ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa gov/permits <br /> t A� . OJECT SITE INFORMATION <br /> PROJECT ADDRESS: 12815 Bothell-Everett Hwy Everett, WA 982085 <br /> BUILDING AREA(if residential,new construction, remodel,or addition)N/A SF <br /> BUILDING TYPE: D SFR-DETACHED D SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: I COMMERCIAL <br /> USE OF BUILDING: Silver Lake Elementary School <br /> ELECTRIAt'APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 11438.70 <br /> NUMBER OF DEVICES (if low voltage): 5 <br /> FIRE ALARM? D YES ®NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): N/A <br /> DESCRIPTION OF WORK: Provide, Install, Terminate, Test and Label: 1. [05] Cat6 Riser Rated cable installed <br /> between the nearest MDFIIDF's and [05] New CCTV Camera location. 2. Where replacing existing camera, remove <br /> existing camera and return to Owner. 3. Install new camera with mounts and hardware. <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett School District TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> c,n Everett STA-E WA ZIP 98201 <br /> OWNER PHONE: (425) 3854000 OWNER EMAIL: sbarbano©everettsd.org <br /> CONTRACTOR NAME: CTS <br /> CONTRACTOR ADDRESS: SIRES"'2720 S Ash St <br /> c,TY Tacoma STATE WA ZIP 98409 <br /> CONTRACTOR PHONE: (206) 686-2000 CONTRACTOR EMAIL: tammyo@cableCTS.com <br /> CONTRACTOR LIC.#(REQUIRED): CTS* TS881 BK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 048173 <br /> PRIMARY CONTACT: 0 OWNER QI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (425) 633-0070 <br /> Sean Moena CONTACT EMAIL: seanm@cableCTS.com <br /> AGREEMENT I hereby certify that t nave 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 /> City of Everett Oficial Use Only <br /> PERMIT# <br /> E \ ?Oto- 0I <br /> Owner/AutfrortzattAgent ure Date (Revised 9/23/2016) <br />