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67/15/2015 18: 04 2062911500 PAGE 02/02 <br /> ELECTRICAL p�ERMIT A,PPLiCAT1�C3N <br /> C�Ty pF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STR�ET, EVERETT, UVA 9'8201 <br /> 4�5-Z57-8810 - FAX 425=257-8857—www.everettwa.gov <br /> 1330 S�OCKEFEI,LEIZ AVE : � 2nd �'loo�..'t.•i;-. . <br /> PRaJECT AbpFZESS . � <br /> Providence �edical Gentex. 1321 Coiby Ade �verett WA 982�1 <br /> . , ciry , Sta4elZip . Pnoiie <br /> Ovvner hAail Address � , �. . . <br /> Pxovidence k�egional �9ec1zCa1 Centez, MO�, 1330 Rockefellex Ave Evezett WA 98201 425-261-�74 <br /> Cit State/Z!p Phone <br /> Tenant Mail Address y <br /> V'eGa E�,ect�ic, 5614 7�h I�ve' S/PO BOx $0.46-7 Se�'Ct1e WIa 98;109 206-320-7114• <br /> StatefZ,i Pnone <br /> EleCtrica!COntraCtor Maii Ad,dress Gity P <br /> vECAECI542�U 601196731 <br /> . State ticense Number(r�quired) Ciry of Everett Business License Number(required) <br /> �'ledical o�fice Bidg $3574 .00 <br /> � Proposed Use of Ruildirtg � � Cofltraci Price of Work �Si.mplexGriz�nell <br /> JaneC Stebbins .206-2�1-.�.963 , <br /> . - .jast�bbins@simpleYqx'inne,ll:com <br /> Square Footage Qf residential new construction,remodel or additfbnJ Contaet PersonlContact NumberlEmail <br /> 89 <br /> Number of devlces(If low voltage) <br /> Description of Wo�k to Be Done- Modify exis'ting �ire alarztt sysCem for 2nd floor tenant <br /> improve�nent. Joint ven'tuYe b�tween Simple�Grinnell b <br /> V�CA EleC'C�'ic. <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 8106 <br /> J he�eby certlfy thaf 1 have read and examined fhis appllcaGon and know the same to be true and <br /> correct_ AU provlsions oflaws�nd ordJnences go�eming this type of work will be cornpleted <br /> whether specvfisd herern or»ot. The granting of a permit does not presume to give autirority to PERMIT# <br /> violate or ca�a1 fhe pr�vfsfons of any ofhel'sfaEe Or loCel I8w�gulating COAsfruCtlOn orthe rr � �,�f �� <br /> performsnc�of construction. That!am authorized by the owner of thfs property fo perform trre C /� �a+� <br /> work for whTch appllcation is made and!comply with the State Conftacior�Law 95.27 RCW and (� !� <br /> 296.200 WAC. <br /> (/ r r / <br /> ' � /^ 7115/15 <br /> a u Daie <br /> � <br /> - o��� 1�6� e�-u S r�N f�G�-KCrI�iNNc��--- ���c <br /> i2EVISED OCJosJ2098 � <br /> �4-t��n�N � - !J D' ru r�� C f��4 � Ee� - ak 5 , . <br />