3927 RUCKER AVE BASE FILE 2019-09-24

1147-7- L ECTRICAL PERMIT APS LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 3927 Rucker Avenue BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: IX COMMERCIAL USE OF BUILDING: Medical Bldg. ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 16,122.00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES El NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Gunderson WIC Remodel Extending (6) circuits, adding outlets and lights. Cut in outlets CONTACT INFORMATION OWNER NAME: The Everett Clinic TENANT NAME(If Commercial): The Everett Clinic OWNER MAILING ADDRESS: STREET 3901 Hoyt Avenue ry CITY Everett STATE WA ZIP 98201 OWNER PHONE: 475-259-0966 OWNER EMAIL: N/A CONTRACTOR NAME: Dutton Electric Company, Inc. CONTRACTOR ADDRESS: STREET 12407 Mukilteo Speedway. A-170 CITY i.ynnwnnrl STATE WA zip 98087 CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAIL: infoOrIuttonelectric.com CONTRACTOR LIC.#(REQUIRED): DUTTOEC 137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):019811. PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Brad Morin CONTACT PHONE: 425-409-4854 CONTACT EMAIL: brad@duttonelectric.com 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 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 local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE VA � �r a V PERMIT# Pita Smith gpOSEe,ta@utttctrk om.OU.—O•DECO CN.Peita ?),05 ^ peasan arras:to the amu'acy and Integrity of the documem / Date POfe.05.07153209-0700' Owner/Authorized Agent Signature Date (Revised 10/12/2015)