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ELECTRICAL PERMIT APPLICATION <br /> ?1/% .1 <br /> _ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov vvww.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: Monroe Elementary School 10901 27th Ave SE Everett, 9 208 <br /> BUILDING AREA(if residential, new construction, remodel,or addition)approx. 868 SF <br /> BUILDING TYPE: ❑ SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS. ®COMMERCIAL <br /> USE OF BUILDING: Portable Classroom <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2423.00 <br /> NUMBER OF DEVICES (if low voltage): 10 <br /> FIRE ALARM? El YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# (if applicable): <br /> DESCRIPTION OF WORK: Add Smoke Detector, Heat Det above ceiling, Horn/strobes, Pull Station & <br /> NAC panel to new portable classroom <br /> CONTACT INFORMATION eko41v1 <br /> OWNER NAME: Everett School District TENANT NAME(If Commercial): "= "" "m C ••I <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> crTY Everett STATE Wa ZIP 98201 <br /> OWNER PHONE: 425-3854000 OWNER EMAIL: <br /> CONTRACTOR NAME: Convergint Technologies LLC <br /> CONTRACTOR ADDRESS: STREET 450 Shattuck Ave Suite 100 <br /> crnr Renton STATE Wa ZIP 98057 <br /> CONTRACTOR PHONE: 253-732-5962 CONTRACTOR EMAIL: glenn.smith@convergint.com <br /> CONTRACTOR LIC.#(REQUIRED): CONVETL984BQ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 42662 <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-732-5962 <br /> Glenn Smith CONTACT EMAIL: glenn.smith@convergint.com <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 /> City of Everett Official Use Only <br /> PERMIT# <br /> E <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) ' <br />