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477 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: North Middle School, 2514 Rainer Ave, Everett, WA 98201 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) 1,500 SF <br /> BUILDING TYPE: 0 SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS ® COMMERCIAL <br /> USE OF BUILDING: Middle School <br /> ELE7R1CAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2,500( <br /> 1 <br /> NUMBER OF DEVICES (if low voltage): less than 20 <br /> FIRE ALARM? ❑YES El\NO <br /> ASSOCIATED BUILDING PERMIT# (if applicab4 . <br /> DESCRIPTION OF WORK: Portable Classrooms - Installation of approximately (11), but no more than 20 Cat6 <br /> telephone/data low voltage cables. <br /> CONTACT INFORMATION <br /> OWNER NAME: Everett Public School District TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> c,T.r Everett STATE WA ZIP 98201 <br /> OWNER PHONE: 425-385-4190 OWNER EMAIL: <br /> CONTRACTOR NAME: Structured Communications <br /> CONTRACTOR ADDRESS: STREET PO Box 1368 <br /> crry Snohomish STATE WA ZIP 98291 <br /> i.ONTRACTOR PHONE: 425-321-5343 CONTRACTOR EMAIL: dustin.duke©gostructured.com <br /> CONTRACTOR LIC.#(REQUIRED): STRUCC*8920L CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 050586 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-367-3977 <br /> David Meyer CONTACT EMAIL: david.meyer@gostructured.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 /> Ifti/-21 ' ICkg—CL-5 8.2-q..Z0/7 E \ --1+0 . - - 2— <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />