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2016-06-17 12:24 Perkins Pacific OKC 4056046686 >> 425 257 8857 P 2/2 <br /> • <br /> 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 <br /> PROJECT ADDRESS <br /> Providence Health 916 Pacific Ave Everett WA, 98001 26=So7�3, <br /> Owner Mall Address city State/Zip Phone <br /> Tenant Mail Address City Stale/Zip Phone <br /> Pacific Power Group 805 Broadway Street, #700 Vancouver WA 98660 '­­ <br /> Efectrlcal Contractor Mail Address City State/Zip Phone <br /> EC PACIFPG867D7 047977 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> $1500.00 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: 4 Hour load bank test of 3 emergency standby <br /> generators. - 889506 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 50 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and J <br /> correct. All provislons 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 l am authorized by the owner of this property to perform the IUr(1 (J <br /> work for which application is made and I comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> �i 06/17/2016 <br /> S' alure �— Date <br /> REVISEn OaD5/2014 <br />