Laserfiche WebLink
04e, .ECTRICAL. PERMIT A_ LICATION <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 www.everettwa.gov/permits <br /> 4,4v5 PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: Eisenhower Middle School, 10200 25th Ave SE, Everett, WA 98208 <br /> BUILDING AREA(if residential,new construction,remodel,or addition)896 SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Education - Portable <br /> ` _4 ELE TRIC 1.APPLICA'II'ION INFORMAT10N <br /> CONTRACT PRICE OF WORK: $ 2690 <br /> NUMBER OF DEVICES (if low v Itage): <br /> FIRE ALARM? ®YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Provide heat and smoke detection as well as notification for portable classroom. <br /> _" ONTACTINFORMATION' <br /> OWNER NAME: Eisenhower Middle School TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 10200 25th Ave SE <br /> Cm Everett STATE WA ZIP 98208 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Convergint Technologies(David Widener) <br /> CONTRACTOR ADDRESS: STREET 450 Shattuck Ave S, Suite 100 <br /> cm• Renton STATE WA zip 980 <br /> CONTRACTOR PHONE: 206-354-8399 CONTRACTOR EMAIL: david.widener@convergint.com <br /> CONTRACTOR LIC.#(REQUIRED): CONVETL984BQ CITY OF EVERETT BUSINESS LIC.#(REQUIRED 42662 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-354-8399 <br /> David Widener CONTACT EMAIL: david.widener@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 lam 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 l23 <br /> Owner/A orized Agent Signature Date (Revised 9/23/2016) <br />