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ELECTRICAL PERMIT APFLICATION <br /> 01. ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: Monroe ES - 10901 27h Ave SE, Everett, WA 98208 <br /> BUILDING AREA(if residential, new construction, remodel, or addition)900 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Education <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ $35,000 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 21 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Addition of a single classroom portable building to existing building infrastructure. <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett Public Schools TENANT NAME(If Commercial): .' <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> coy Everett WA <br /> STATE Zip 98201 <br /> OWNER PHONE: 425-923-6251 OWNER EMAIL: JCollins@everettsd.org <br /> CONTRACTOR NAME: TBD- Public Bid <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE <br /> ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER (Please Specify) Electrical Engineer <br /> CONTACT NAME: CONTACT PHONE: 206-436-0465 <br /> Jon Beade, PE - Hargis Engineers CONTACT EMAIL:jon.beade@hargis.biz <br /> AGREEMENT:I hereby certify that/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 riot 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 Official Use Onfy <br /> For________— <br /> PERMIT# <br /> 34°11gE 3 o3 - (L-M <br /> Owner/A horized Agent Signature Date (Revised 9/23/2016) <br /> Z <br />