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41PI� 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 I www.everettwa.gov/permits <br /> PROJECTSITE INFORMATION <br /> PROJECT ADDRESS: 2416 Colby 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' 0 COMMERCIAL <br /> USE OF BUILDING: Everett High School <br /> ELECTRICAL.,APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 23667.00 <br /> NUMBER OF DEVICES (if low voltage): 8 <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. [08] Cat6 Riser Rated cable installed <br /> between the nearest MDF/IDF's and [08] 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 /> CONTACT INFORMATION <br /> OWNER NAME: Everett School District TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 390OµBroadway <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: (425)385-4000 OWNER EMAIL: sbarbano@everettsd.org <br /> CONTRACTOR NAME: CTS <br /> CONTRACTOR ADDRESS: STREET 2720 S Ash St <br /> cFry 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: 0 OWNER 0 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 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 WA C. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> r,-- E a0(0 11( <br /> Owner/Authorl Afi a ignature Date (Revised 9/23/2016) <br />