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u <br />ELECTRICAL PERMIT APPLICATIDN <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 />3305 NASSAU ST <br />PROJECT ADDRESS <br />PROVIDENCE GEN MED CTR ^ <br />Owner Mail Address <br />Tenant <br />MAPLE CREST ELECTRIC <br />Electrical Contractor <br />MAPLECE170JA <br />State License Number <br />TI <br />Proposed Use of Building <br />Mail <br />21628 84TH AVE SO <br />Mail Address <br />City <br />_ j Sf �G�, <br />City <br />KENT <br />City <br />4,012 <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />Description of Work to Be Done: remodel existing building — j/V 1 I^� i��j <br />State/Zip <br />State/Zip <br />WA 98035 <br />State2ip <br />$65,152.00 <br />Contract Price of Work <br />Phone <br />Phone <br />253-872-4712 <br />Phone <br />Contact Person {Plan Review) <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE•IS 3105 � �"� � f`�� <br />1 hereby certify that 1 have read and examined thrs application and know the same to be true and v l <br />correct. A!1 provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give autho�rty to pERMIT# <br />violate or cancel the provisions of any other state orloca! law regulating construcfion or the � <br />performance of construction. That ! am authorized by the owner of tl�is �roperfy to perform the E I�� i--� — O� <br />work for which application i^s made and 1 comply with the State Confractors Law 18.27 RCW and <br />296.200 WAC.� ) i I <br />� <br />a�wseo 3�zat3 <br />�'��l C �� <br />