Laserfiche WebLink
JUN/25/2014/WED 09.23 AM <br />� <br />FAX No,425-419-2121 <br />� <br />ELECTR�CAL P�RMiT APPLIC,�►T�ON <br />c�r� oF �vEa�T-r ����niT sERv�c�� <br />3200 CEbAR STR�ET, EVERETT, WA 90^2�1 <br />42�-257�8810 � FAX 425-257-8857 — www,everettwa.org <br />916 Pacific Ave. EvereCt WA 98201 � <br />pl�OJ�CT ADPRESS <br />Own <br />�� Y�� <br />Providence Medical <br />1"en8nt <br />Mail Address <br />916 1'Acific Ave <br />Mait Address <br />Clty <br />�vereLL <br />Clty <br />5tatelZip <br />t�iA 98201 <br />SC9te{Zip <br />P, 001/001 <br />Phone <br />Phone <br />Wl'CS Tn[ernat'ronal Tnc. 15241 NE 90th St �2edmqnd WA 95052 425-433-2677 <br />Electrical Contractor Mall Address city State/zlp Pnone <br />WPCSIII912M1 <br />State License Number <br />Cornrnercial / Medical <br />Proposed Use of Building <br />r 000s �t <br />Square Footage (If residential new ConstruCtlon, remoefel dr addition) <br />� <br />Number of davices (if Ipw voltage) <br />$1,000.00 <br />Contract Price of Work <br />Bruce Ross a '�XrPCS.com <br />ContaCt F�etson (Pian R�viewj <br />Description of Work to ee f�one: Termrn�tte eabling for the seeurit� panel for a 20 door system device �n� e�ble installation is by <br />others <br />CIiY OF EVERETT LOCAL SALES TAX CODE IS 31a5 <br />! hereby certify that I have read and examined thi5 applicatian and know ihe same to be true and <br />correcf, A!I provlsrons ot laws and ordinances goveming this type of work will be completad <br />whefher specified Hereln or not. rhe granting of a permif does not presume fo glve authorlty fo <br />violate or cance! the provisions of any pthet'state or loeal law r'egul&ting eonstructron or ihe <br />performance of construction. Thaf l am aelthonzed by th�: owner of this properfy to perform the <br />work fo�hieh applicafion is made and ! comply with the state Contractors Law 18,27 RCW and <br />/ <br />re <br />RPVISED 3/20/79 <br />6/25/14 <br />DaCe <br />F�� <br />�� ` � O <br />P�RMIT# <br />E L`�'��-(�� <br />