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ELECTRICAL PERMIT APPLICATION <br /> I�►', CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps a'7everettwa.gov I www.everettwa.govfpermits <br /> \ A �.. yAlar• Deo'g '�i .,�1 �ll3a �! '.1�v,�!, <br /> PROJECT ADDRESS: 1110 Poplar 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: CO COMMERCIAL <br /> USE OF BUILDING: Hawthorne Elementary School <br /> CONTRACT PRICE OF WORK:$ 6881.70 <br /> NUMBER OF DEVICES(if low voltage): 3 <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. [03]Cat6 Riser Rated cable installed <br /> between the nearest MDF/IDF's and[03]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 /> 'E��2�'' <br /> _ <br /> OWNER NAME:Everett School District TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3900 Broadway <br /> civ 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 /> cnY Tacoma STATE WA ZIP 98409 <br /> CONTRACTOR PHONE: (206)686-2000 CONTRACTOR EMAIL: tammyo@cableCTSS.com <br /> CONTRACTOR LIC:#(REQUIRED): CTS**TS881 BK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 048173 <br /> PRIMARY CONTACT: 0 OWNER ®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 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. Thegranting 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 l 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 RC W and 29&200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> . gOC,„ - o�3 <br /> caner/Autho : _, Date (Revised 9/23%2016) <br />