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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 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ‘ , sl ,t} ., ;.r `t`': r:,%A _a; _ a - I .,, ''':•` ,a 6 . yam' ; <br /> PROJECT ADDRESS: 3700 Federal Ave Everett, WA 98201 <br /> BUILDING AREA(if residential,new construction,remodel,or addition)N/A SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ®COMMERCIAL <br /> USE OF BUILDING: Jackson Elementary School <br /> '.. ,a�. '�:�.:a F�"a%u �,����.„�<h>.33�.- ,.� :.:-.-. .,.4»a�Av'^� a3,� ; ,.,... ae..�a..'Ya��;'x::- . .`•. .... ..w.< =moi 'fix. � ,.ue.. .,. �i� � <br /> CONTRACT PRICE OF WORK:$ 3033.80 <br /> NUMBER OF DEVICES(if low voltaz1: 1 <br /> FIRE ALARM? 0 YES ®NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): N/A <br /> DESCRIPTION OF WORK: Provide, Install, Terminate, Test and Label: 1. [01] Cat6 Riser Rated cable installed <br /> between the nearest MDF/IDF's and [01]New CCTV Camera location. 2. Where replacing existing camera, remove <br /> existing camera and return to Owner. 3. Install new camera with mounts and hardware. <br /> OWNER NAME:Everett School District TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: (425)3854000 OWNER EMAIL: sbarbano@everettsd.org <br /> CONTRACTOR NAME: CTS <br /> CONTRACTOR ADDRESS: STREET 2720 S Ash St <br /> CITY Tacoma STATE WA ZIP 98409 <br /> CONTRACTOR PHONE: (206)686-2000 CONTRACTOR EMAIL: tammyo@CableCTS.COm <br /> CONTRACTOR LIC.#(REQUIRED): CTS**TS881 BK CITY OF EVERETT BUSINESS LIC.#(REQUIRED):048173 <br /> PRIMARY CONTACT: ❑OWNER P.)CONTRACTOR 0 OTHER{Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (425)633-0070 <br /> Sean Moena CONTACT EMAIL:seanm@cableCTS.com <br /> AGREEMENT:I hereby certify that 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!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 /> VIP . E lcZ.0(0- 01q <br /> Owner/Authorized Age na Date (Revised 9/23/2016) <br />