Laserfiche WebLink
12/01/2015 09:55 2062911500 PAGE 01/01 <br /> 9 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PrERMIT SERVICES <br /> OOL 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I vAvvv.everettwa'00V/PerM its <br /> u ,kIN <br /> Xffi=116,1191,M'' <br /> rPROJECTADDIRPSS: 1321 Colby Ave <br /> 131 <br /> BUILDING ARIA(if residential,new construction,remodel,or addition} SF <br /> IBUILDING TYPE: 0 SFR-DETACHED I-] SFR-ATTACHED 0 DUPLEX [3 MULTI-FAMILY-#OF UNITS: EM COMMERCIAL <br /> USE OF BUILDING: Hospital <br /> VON <br /> CONTRACT PRICE OF WORK: $ 3200.00 <br /> NUMBER OF DEVICES(if low voltage): 2 <br /> FIRE ALARM? N1 YES [7 NO <br /> ASSOCIATED BUILDING PERMIT (if applicable): <br /> ��i AiArm nvstin PRMn Cr�lhy <br /> DESCRIPTION OF WORK: Arid (2� dPyJr­uq to —i ztinrl f en <br /> Campus, D-Wing B2 level electrical room. Joint venture between <br /> VEA Electric ana _9j—=lexGrjnnel_l_ <br /> gg <br /> Ei SINKER,$ .11110. a <br /> MR <br /> OWNER NAME: Providence Regional Med Ctr TENANT NAME If Commercial): PRMC Everett Colby Campus <br /> OWNER MAILING ADDRESS: STRUT 1321 Colby Ave, WA 98201 <br /> Crry Everett STATE ZIP <br /> OWNER PHONE: 425-299-2995OWNFR 1EMAIL: ...... ..... <br /> CONTRACTOR NAME: IJECA Electric <br /> CONTRACTOR ADDRESS: STREET 5614 7th Ave. S.1?0 Box 80467 <br /> CITY Seattle STATE WA zP 98108 <br /> _]CONTRACTOR PHONE: 206-436-5200 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#REQUIRED): VECAEC1542MU CITY OF EVERETT BUSINESS LIC,#(REQUiRE1)): 601190731 <br /> ........ <br /> PRIMARY CONTACT: OOWNER 13CONTRACTOR MOTHER(Please Speolfy) SimplexGr;Lnnell <br /> CONTACT NAME: Janet Stebbins CONTACT PHONE: 206-291-1468 41C <br /> CONTACT EMAIL; jastebbins0simplexgrinnell-com <br /> AGREEMENT.*T hereby Certify that I have mad and examined this application and know the same to be true and correct All ptovislons Of laws and ordinances governing(his <br /> type of work will be completed whether specified herein or not The granting of a permit does not presume to give authority to violate or camel the provisions of any other state of <br /> local law regulating construction Or the performance of constructfon. That I am autharized by the owner of this property to perform the work for which application 1.9 mads and I <br /> comply with the State Contractors Law 16,27 RC and 296.200 WAC. City of Everett official Uae Only <br /> FEE <br /> O <br /> PERMIT# <br /> Data (Revised 1011212015) <br /> Fr--rfALitflo—rii-e-d�kgorit'�519ti.9ture Ir <br /> f-e'a'tt fiv — <br />