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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />900 Pacific Ave.Everett WA <br />PROJECT ADDRESS <br />Providence <br />Owner Mail Address <br />PRMCE 5th Floor Pavilion Sleep Study <br />Tenant <br />Foy Group <br />Electrical Contractor <br />FOYINEC015CH <br />State License Number <br />Medical <br />Proposed Use of Building <br />Mail Address <br />City <br />C ity <br />2400 NW 80th Street #118, Seattle <br />Mail Address City <br />1000 Remodel <br />Square Footage (If residential new construction, remodel or addition) <br />2 <br />Number of devices (If low voltage) <br />State/Zip <br />State/Zip <br />Phone <br />Phone <br />WA/98117 206-937-6150 <br />State/Zip Phone <br />$450.00 <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: Low Voltage Controls for Energy Management <br />HVAC Control for 2 VAV's. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �� �a <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whefher specified herein or not. The granting of a permif does not presume to give authority to PERMIT# <br />violate or cancel the provisions of any other state or local law regulating construcfion or the ^ ��� r�`�� <br />performance of construction. That 1 am authorized by the owner of this property to perform fhe t Q <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Jim Jordan <br />Sianature <br />REVISED 3/20/13 <br />2/4/15 <br />Date <br />