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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov � www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 9700 HOII�/ DfIV2 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) 1680 SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: � COMMERCIAL <br /> usE oF aui�oiNc: School - Modular Classroom <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 16230.00 <br /> NUMBER OF DEVICES if low volta e): 26 <br /> FIRE ALARM? m YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# if applicable): <br /> DESCRIPTION OF WORK: Replace existing portable classroom 'E'with new modular classroom. <br /> Joint venture between SimplexGrinnell & McGann Electric. <br /> CONTACT INFORMATION <br /> OWNER NAME: MUkIIteO SCh001 DIStfICt TENANT NAME(If Commercial): ACeS Hlgh <br /> OWNER MAILING ADDRESS: srReeT 9401 Sharon Drive <br /> c,n Everett STATE WA Z,P 98204 <br /> owNER PHONE: 425-356-1330 OWNER EMAIL: n/a <br /> coNrwaCTOR rvAnne: SimplexGrinnell <br /> CONTRACTOR ADDRESS: srrzeeT 952� ��th AV@ S. SUIt2 'I OO <br /> c„Y Seattle srATE WA z,P 98108 <br /> CONTRACTOR PHONE: 206-291-1400 CONTRACTOR EMAIL: JBSt@bblllS@SIt11pleXgfllltl@II.COI71 <br /> CONTRACTOR LIC.#(REQUfRED): SIMPLL*981 SG CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0502�� <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-2J'I-14C$ <br /> SIC11p�2XGt"Itltle����allet StebfJIC1S �pel"tlllt� CONTACT EMAIL:�aStebblflS@SIt11pleXgrinn211.COn1 <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 comp/eted whether specified herein or not. The granting of a permrt does not presume to give authority to violate or cancel the provisions of a�y other state or <br /> local law regulating construction or the performance of const�uction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> compiy wifh the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Officia/Use Only <br /> o�9�caiiY,�9„e�i��r,a�ecsce�b��s PERMIT# <br /> �anet Stebbins �"`°_'AOLS"`bb'°s.°-5'm�'.."`"°°'.", 7/20/17 E <br /> u—Elt�ctncalConttructionOprratlons, �� �� � � <br /> •mail�=jruebbins<�simplexgrinnrll com,r—US <br /> Datc:201/.OI20 16223R-07'00' <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br /> '�� <br />