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ELECTRICAL PERMIT APPLICATION <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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 10901 27th Ave SE <br /> BUILDING AREA(if residential,new construction,remodel,or addition)887 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED A DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Portable Classroom <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 5,812 <br /> NUMBER OF DEVICES(if low voltage): 20 <br /> FIRE ALARM? 0 YES IZINQ <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Installation of Cat6 data cabling to new portable classroom. <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett School District TENANT NAME(If Commercial): Monroe Elementary <br /> OWNER MAILING ADDRESS: MEET 3900 Broadway <br /> ca w Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-385-4000 OWNER EMAIL: <br /> CONTRACTOR NAME: Structured Communications <br /> CONTRACTOR ADDRESS: smscr PO Box 1368 <br /> an Snohomish STATE WA 2p 98291 <br /> CONTRACTOR PHONE: 425-321-5343 CONTRACTOR EMAIL: dustin.duke@gostructured.com <br /> CONTRACTOR LIC.#(REQIIRED): STRUCC*8920L CITY OF EVERETT BUSINESS LIC.#(REQUIRED):050586 <br /> PRIMARY CONTACT: Cl OWNER Cd CONTRACTOR 0 OTHER(Please.Specify) <br /> CONTACT NAME: CONTACT PHONE: 425_367_3977 <br /> David Meyer CONTACT EMAIL:david.meyerrgostructured.com <br /> AGfiEEMENT.•I hereby certify that l 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 authonly to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That lam 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 /> P 41 <br /> PERMIT". <br /> _ '! + Wil& LPE .'0? ''4° 13 <br /> Owne , .Agent Sigature Dat (Revised 9123/2016) <br />