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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 /> 2930 MAPLE STREET <br /> PROJECT ADDRESS <br /> GROUP HEALTH <br /> Owner Mail Address City State/Zip Phone <br /> SAME <br /> Tenant Mall Address City State/Zip Phone <br /> Prime Elf disc 13301 SE 26-fl' Si 13d(ewe. w 11 40005 ai2.;•'741-5706 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> PRIMEEIIS4 CO 14,565 <br /> State License Number Contract Price of Work <br /> GROUP HEALTH EVM MED HOME <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Square Footage(If residential new construction,remodel or addition) <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Provide and install (16) Duplex recpt. (4) new power poles and <br /> furniture connections. Remove and re-install (7) existing 2x4 fixtures install (6) <br /> new 20a circuits to support outlets. Work done in rooms S115,S191,N105,N156,N186,N187 <br /> 6162731 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that!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 PER VIfl# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That lam authorized by the owner of this property to perform the E ( 7 <br /> work for which application is made and I comply with the State Contractors Law 96.27 RCW and <br /> 296.20, ' • <br /> C <br /> ure <br /> ftLA <br /> REVISED Y20113 <br />