8625 EVERGREEN WAY DSHS 2017-10-20

& 0 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 8625 Evergreen Way, 2nd floor, Everett, WA 98208-2645 BUILDING AREA(if residential,new construction,remodel,or addition)3,300 SF BUILDING TYPE: 11 SFR-DETACHED 11 SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL .USE OF BUILDING: Washin&fiS*te Department of Health and Social Services ELEC RICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK� 2,500 NUMBER OF DEVICES (if low Itage): 33 FIRE ALARM? 0 YES \\_ _1�1�0 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Provide and install 33 each speakers and cables for paging system CONTACT INFORMATION OWNER NAME: Washington State Department of Health and Social Services TENANT NAME(if Commercial): Washington State Department of Health and Social Service OWNER MAILING ADDRESS: ,....8625 Evergreen Way My Everett STATE WA zj,98208-2645 OWNER PHONE: Donna Leis —TOWNER EMAIL:etsd@dshs.wa.gov CONTRACTOR NAME: CTS CONTRACTOR ADDRESS: ITIEET2720 S Ash Street CITY Tacoma STATE WA zip 98409 CONTRACTOR PHONE:206-686-2000 ezt 230 1CONTRACTOR EMAIL: alc@cablects,com CONTRACTOR LIC,#(REQUIRED): CTS**TS881BK ICITY OF EVERETT BUSINESS LIC.#(REQUIRED(b48173 PRIMARY CONTACT: 11 OWNER 2 CONTRACTOR 11 OTHER(Please Specify) CONTACT NAME: CONTACT HONE: 206-686-2000 ext 107 ,Heather Nunez CONTACT EMAIL:heathern@cablects.com AGREEMENT I hereby certify that I have read and examined this application and know the same to be true and correct. Ail provisions of laws and ordinances governing this type 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 local Jaw 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/ comply with the State Contractors Law 18.27 RC and 296.200'NAC. City of Everett Official Use Only PERMIT# E Owner/Authorized Agent Signature Date (Revised 912312016)