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ELEC RICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3,..so CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8i:i,7 1(E)everetteps©everettwa.gov I www.everettwa.goviperm its <br /> PR 0 ECT SITE INFORMATION <br /> , <br /> PROJECT ADDRESS: 3900 Broadway <br /> q t <br /> BUILDING AREA(if residential,new construction,remod or addition)Remodel SF g7 Li Li tcq• -.1--f <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTA*1 ED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: School District 11 <br /> ll 1 <br /> , <br /> ELECTRI or L APPLICATION INFORMATION <br /> 1 <br /> CONTRACT PRICE OF WORK:$ 19197.09 <br /> NUMBER OF DEVICES(if low voltage): 6 !I I <br /> FIRE ALARM? 0 YES 0 NO :'I <br /> ASSOCIATED BUILDING PERMIT#(if applicable) <br /> DESCRIPTION OF WORK: <br /> At the CRC there is 1 2strand 50 micron fiberj Mat has 2 connectors. Runs 3 cameras via POE switch. <br /> At the Athletics Building has 1 2strand 50 mi 01,n that feed a media converter 2 connectors. <br /> il <br /> i!! <br /> IP •NTACT INFORMATION : <br /> ,i <br /> OWNER NAME:Everett School District No.2 1!1 TENANT NAME If Commercial: 4 Li/A A IA !! OW& <br /> OWNER MAILING ADDRESS: STREET 3900 Bro41:.way / , • <br /> 1.1 Everett :! sTATE WA Zlp 98201 <br /> OWNER PHONE: 425-3854200 <br /> 1,1 OWNER EMAIL: ktoyn©everettsd.org <br /> CONTRACTOR NAME: CTS 1!1 <br /> CONTRACTOR ADDRESS: STREET 2720 Sou ii Ash Street <br /> ery Tacoma 1! STATE WA zip 98409 <br /> i <br /> CONTRACTOR PHONE: 206-686-2000 1:I CONTRACTOR EMAIL: customerservice©cableCTS.com <br /> CONTRACTOR LIC.#(REQUIRED); CTS**TS881BN} CITY OF EVERETT BUSINESS LIC.#(REOUIRED):048173 <br /> PRIMARY CONTACT: DOWNER 0 CONTRACTi;t 0 OTHER(Please Specify) Project Manager <br /> CONTACT NAME: 11 CONTACT PHONE: 425-633-0070 <br /> is <br /> Sean Moena ; CONTACT EMAIL:seanffl@fgCtSCOMS.cOM <br /> ' <br /> AGREEMENT'I hereby certify that I have read and examined this a;.,,i icatkm and know the same to be true and correct Alt provisions of laws and ordinances governing this type <br /> of work will be completed whether specified herein or not. The gra 1.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;construction,ii 1! at!am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WA,0, <br /> il <br /> 11 <br /> II <br /> ;I City of Everett Official Use Only <br /> / PERMIT# <br /> (y), 0 it „ <br /> i I 40 :!1 0 1 1-7 E \1 \2-nt5 <br /> Owner/• • ho sad Agent gnature te (Revised 9/23/20161 <br /> 1 <br />