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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 /> 1700 13th St Hosp #1 <br /> PROJECT ADDRESS <br /> Providence Colby Campus 1 700 13th St Everett WA 98201 4252380129 <br /> i <br /> Owner Mail Address city State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Pacific Power Group 805 Broadway Street, #700 Vancouver WA 98660 288.39S9Wl <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> EC PACIFPG867D7 047977 <br /> State License Number(required) City of Everett Business License Number(required) <br /> $250.00 <br /> Proposed Use of Building Contract Price of Work <br /> Amanda Nokes 425-282-2399 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> i Description of Work to Be Done: 2 Hour load bank test of emergency standby <br /> generators. - 893771 Colby Campus Hospital Gen 1 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /hereby certify that l 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 PERMIT# <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 E <br /> work for which application is made and t comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> 04/12/2017 <br /> ign Date <br /> REVISED 08/06/2074 <br />