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DEC—a5-2011 11�27 VECA E�ECTRIC 2a676�05�5 P.02 <br /> ELECTRICAL PERMIT APPLICATInN <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAP. STREET, EVERETT, WA 9820� <br /> 425-257-8810 - FAX 425-257-8857 -vnvw.everettwa.or9 <br /> APPLICATIONS ARE AGCEPTED FROM 8 AM TO A PM r ;Z —(�--(J <br /> �,�// � -03 <br /> 12800 Bothell Everett Hwy,Suite 1fi0 Everett,WA <br /> PROJECTApDRESS <br /> Providence Hospital 12800 Bothell Everett Hw Everett WA,98208 425.316.50�0 <br /> Owner <br /> Mail Adaress city State2ip Pnone <br /> Seatlle Childiens Hospital PO�ox 5371 Seanle WA, 981o8 206.987.2000 <br /> Tenant <br /> MailAddress City State/Zip Phone <br /> VECA EleCC.ic PO 80X 80467 Seatt?e i'1A 99109 206-;36-5200 <br /> Slale2i Phone <br /> Electrical Contractor Pdail Address c'dy P <br /> 65,000 <br /> VECAcCT542N,U COntrad PfirR of Work <br /> S:ate License Number <br /> Medical Off�ce <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Descnption of Work to Be Done: <br /> 3,800 square foot TI. Re-use ezisling lighting. Add(27)oullets,(13)F'�a Alarm�pvicacrbw-vnllapfl <br /> NOTE: WIRING IN NON-DWELLINGS IS RE4UIRED 70 FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX COPE IS a�o5 � 'I '—L_ v'S p <br /> !hertby oortify thaf I have ioad and examined this app�%catron and know fhe same to be lruo and <br /> O <br /> conecL Afl provisions o(/aws and ordinances poVe�mng fhis typa o1 wak wilf bB.ct�mpleted <br /> �vhefher spoal�ed horoin or nol. The g2nting ot a pennd does not presume fo give aulhoriry fo <br /> v;olala or cancal the piovis�ons o!�ny other sf3to oi local law regula6np conSVuchon o�Ih0 <br /> perlormence o/conslruchon. That/am authon:od by the owner ot this propeRy to perfom�the <br /> wo�k for ia�hith appliC3ti0n is made�and i comply wifh tho State Contraerors La�v 1817 RCW and <br /> 296.200 WAC. <br /> �Il <br /> �gn t re Date <br /> TOTRL P.�2 <br />