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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 />916 Pacific Avenue, Everett, WA 98201 �� �1��- <br />PROJECT ADDRESS <br />Providence Health & Services 1700 13th Street <br />Owner Mail Address <br />Fairfax Hospital <br />Tenant <br />The McKinstry Co. <br />Electrical Contractor <br />MCKINCL942DN <br />State License Number <br />Institutional, Hospital <br />Proposed Use of Building <br />10200 NE 132nd Street <br />Mail Address <br />5005 Third Avenue South <br />Mail Address <br />16,293 SF - Remodel <br />Square Footage (If residential new construction, remodel or addition) <br />�� <br />Number of devices (If low voltage) <br />Everett <br />City <br />Kirkland <br />City <br />Seattle <br />City <br />WA 98201 <br />State/Zip <br />WA 98034 <br />State/Zip <br />WA 98134 <br />State/Zip <br />$ 440,823.00 <br />Contract Price of Work <br />425.261.2000 <br />Phone <br />425.821.2000 <br />Phone <br />206.762.3311 <br />Phone <br />Tod Whitt - Electrical PM <br />Contact Person (Plan Review) <br />�"OCQW�� � V`/b�,�-1J1S� • CAr� <br />20� 3 c�� � � g � <br />Description of Work to Be Done: ���/ �'�� ��` L.� (o� C�' ���-9�P �� �,� ��V p"� '� <br />�q; ����� L� (�-►tb � �� � �� �L� C�� �� C�s �� <br />� � �� (�.., '� 4 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 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 />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That I am authorized by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. n a <br />��-/q� �� ? <br />REVISED 3/20/13 <br />FEE <br />�5�0.�� <br />PERMIT# <br />Eigiz-�5�j <br />