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4177 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 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2215 Pine St 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' PJ COMMERCIAL <br /> USE OF BUILDING: Garfield Elementary School <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 3506.30 <br /> NUMBER OF DEVICES (if low voltage): 1 <br /> FIRE ALARM? 0 YES 0 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 /> CONTACT INFORMATION <br /> OWNER NAME: Everett School District TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> c,r,. Everett STATE WA z r' 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 /> „y Tacoma STATE WA Zr' 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 l hereby certify that l 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 t 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 /> -Owner/Authorized Ageot-8iyna Date (Revised 9/23/2016) <br />