9600 HOLLY DR CHALLENGER ELEMENTARY SCHOOL 2017-12-20

Ore Tr !LECTRICAL PERMIT APP ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 9600 HOLLY DRIVE BUILDING AREA(if residential, new construction, remodel, or addition)500 SF BUILDING TYPE: 0 SFR-DETACHED D SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ® COMMERCIAL USE OF BUILDING: SCHOOL ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 17250.00 NUMBER OF DEVICES (if low voltage): 1 FIRE ALARM CONTROL PANEL FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: REPLACE EXISTING FIRE ALARM CONTROL PANEL WITH NEW 4100ES. JOINT VENTURE BETWEEN SIMPLEXGRINNELL AND MAIN STREET ELECTRIC (MAINSEI021DK, UBI#601843635) CONTACT INFORMATION OWNER NAME: MUKILTEO SCHOOL DISTRICT TENANT NAME(If Commercial): CHALLENGER ELEMENTARY OWNER MAILING ADDRESS: STREET 9401 SHARON DRIVE cm' EVERETT STATE WA zip 98204 OWNER PHONE: 425-356-1274 OWNER EMAIL: CONTRACTOR NAME: SIMPLEXGRINNELL CONTRACTOR ADDRESS: STREET 9520 10TH AVE S, SUITE 100 cin, SEATTLE STATE WA ZIP 98108 CONTRACTOR PHONE: 206-291-1400 CONTRACTOR EMAIL: JASTEBBINS@SIMPLEXGRINNELL.COM CONTRACTOR LIC.#(REQUIRED): SIMPLL*981 SG CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 602113334 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-291-1468 JANET STEBBINS/PERMIT CONTACT CONTACT EMAIL: JASTEBBINS@SIMPLEXGRINNELL.COM 7 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 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# dOz,,fritaa,(190114'e4 0' g7/14/2017 E ' 0'1 ' (wner/Ad Agent Signature Date (Revised 9/23/2016) (.__I 1 2-