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RECTRICAL PERMIT APPLICATION <br /> 11111 CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@evereftwa.gov I www.everettwa.gov/permits <br /> nn w f i Y� <br /> gay l , Ca .Ojtt 1 �t iNeoitii f iT Z7, <br /> ; i..�a.., ....: .., - a ,�� .��. ..w.s ......,. F..v.. ..w . ...... . ar.,,'...,,.. ,. ... . .._... ..m.. <br /> PROJECT ADDRESS: 3901 Hoyt Ave <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: IX COMMERCIAL <br /> USE OF BUILDING: Medical Bldg. <br /> l....,. <br /> CONTRACT PRICE OF WORK:$ 500.00 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES Ix�NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Founders building Extend Circuit - Orthaitcot 6Dri <br /> (Job EC1814) <br /> r { <br /> M.. yCOi$iTArci7`loFORM X10..,.or ��>..� <br /> OWNER NAME: The Everett Clinic TENANT NAME(If Commercial): The Everett Clinic <br /> OWNER MAILING ADDRESS: STREET 3901 Hoyt Avenue <br /> cm( Everett STATE WA ziP 98201 <br /> OWNER PHONE: 475-259-0966 OWNER EMAIL: <br /> CONTRACTOR NAME: Dutton Electric Company.Inc. <br /> CONTRACTOR ADDRESS: STREET 12407 Mukilteo Speedway. A-170 <br /> CITY l.ynnwnntf STATE WA ZIP 98087 <br /> CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAIL: info@duttonelectric.com <br /> CONTRACTOR LIC.#(REQUIRED): DUTTOEC137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):019811 <br /> PRIMARY CONTACT: 0 OWNER i CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Brad Morin CONTACT PHONE: 425-409-4854 <br /> CONTACT EMAIL: bradAduttonelectric.corn <br /> AGREEMENT.°T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> , iittal x,signed by Peita Smith qP <br /> t7 us, <br /> i; E pe @duttonelectric.com, <br /> eita Sart ,0-,;-.471=!I=aDttreCs <br /> ,CN the=aPeltaccuracy Smithand <br /> PERMIT# <br /> kra,ateg of this document EC <br /> �Ft� lOate�2018.05.30 08:14:57-07'00' V <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />