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MINN <br /> CITY OF EVERETT <br /> EVERETT ELECTRICAL PERMIT SERVICES <br /> WAS H I NGTON PERMIT 3200 CEDAR STREET EVERETT,WA 98201 <br /> (425)257-8810 <br /> Online Inspection Request: pw.everettwa.gov <br /> PERMIT NUMBER: E2202-128 I DATE <br /> JOB ADDRESS: 12800 19TH AVE SE APN: 28053000407201 <br /> OWNER: USE OF BUILDING: COMMERCIAL ALTERATIONS <br /> PROVIDENCE HEALTH & SERVICES <br /> 1801 LIND AVE SW#9016 TENANT: PRMC <br /> RENTON WA 98057 <br /> PHONE: <br /> PHONE: <br /> DESCRIPTION OF WORK: CONTRACTOR: <br /> 22-248 Install 1-20a 120v dedicated circuit and 4 duplex rec H &M ELECTRIC INC <br /> PO BOX 799 <br /> 22-248 Install 1-20a 120v dedicated circuit and 4 duplex MARYSVILLE WA 98270 <br /> receptacles <br /> 3606580501 <br /> AMPERAGE: CONTRACT PRICE OF WORK: $2,900.00 <br /> PERMITS EXPIRE IF WORK NOT COMMENCED WITHIN 180 DAYS OR CEASES MORE THAN 180 DAYS. <br /> FEES <br /> 07 COMMERCIAL ELECTRICAL $129.5011 ase„anic /�FEB 72022CIpe ETotal Fees $129.50 �"''tRETT <br /> Total Fees Paid $0.00 <br /> Total Fees Due $129.50 <br /> City of Everett Local <br /> Sales Tax Code is 3105. <br /> REMARKS: <br /> PERMIT NO. <br /> E2202-128 <br /> APPLICANT/JOB SITE COPY TREASURER ADDRESS FILE _REV <br />