Laserfiche WebLink
01/27/2015 16:22 2062911500 PAGE 02/03 <br /> • <br /> • ELECTRICAL PERMIT APPLICATION . <br /> 1 , <br /> CITY O.F EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> • 425-257-8810 - FAX 425-257-8857-www.everettwa.arg • <br /> i <br /> 3 K o Ft�lt '. <br /> . 1.-3-24-99-14e (PRMC Colby Campus - MOB - .Level 1 TI) . • <br /> • PROJECT ADDRESS <br /> • <br /> Providence Gen Med.Ctr, PO Bois 1067, Everett, WA '98206-1067 425-25'8-7812• • • <br /> Owner •. • • • • • Mall Address• • City •State/zip Phone • <br /> PRMC )~verett, Colby Campus, 1321 Colby Ave, Everett WA 98201 206-320-2744 <br /> Tenant • Mall Address City Stete/Zip Phone <br /> VECA Electric, 5614 7th Ave 'South,. Seattle •WA 98108-2644 206-579-6895 <br /> Electrical Contractor . • Mall Address City • State/zip •Phone <br /> 'VECAECI542MU 601190731 <br /> State License Number(required) City of Everett Business License Number(required) <br /> • <br /> • <br /> Medical, Bldg • $5625.00 <br /> Proposed.Use of Building • • . • Contract'PFice of Work ' ' <br /> • . . ' . • ' . SimplexGrnnell/Janet Stebbins . <br /> • • 206-291-1468 •PERMIT <br /> Square Footage(If residential new construction,remodel or addition) . Contact Person/Contact Number/Email . . <br /> jastebbins@simplexgrinnell.corn • <br /> 12 • . <br /> • <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Add (12) devices to MOB Level 1 TI. Joint venture between <br /> SimplexGrinnell (permit contact) & VECA Electric (install) . <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herebycertify that I have read and examined this application and know the same to be true and _ _ . <br /> tel' PP <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 'S(y c- I Lia <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. • <br /> / / <br /> .� - / ,11', /'✓tamp4ZICIP1Pall 01/27/15 . . <br /> ature J Date <br /> REVISED 08/042014 <br />