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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 /> 1700 13TH STREET <br /> PROJECT ADDRESS <br /> Providence Colby Campus 1700 13TH STREET Everett WA 98201 4252380129 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Pacific Power Group 805 Broadway Street, # 700 Vancouver WA 98660 2 '9°" <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> EC PACIFPG867D7 047977 <br /> State License Number(required) City of Everett Business License Number(required) <br /> $250.00 <br /> Proposed Use of Building Contract Price of Work <br /> Amanda Nokes 425-282-2399 <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: 2 Hour load bank test of emergency standby <br /> generators. - Providence Colby Campus 897808 <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I 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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That/am authorized by the owner of this property to perform the E I$02- 151 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Kacy Trojcak Kacy Trojcak 02/20/2018 <br /> Signature Date <br /> REVISED 08/06/2014 <br />