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!LECTRICAL PERMIT APRICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 j (E)everetteps@everettwa.gov i www.everettwa.gov/permits <br /> T rC F1T11114 ® ;SITE iftW ® e2.,. f a <br /> PROJECT ADDRESS: 3927 Rucker Avenue <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 /> ,. Y> ,.._ �� � .a. _..,,�M.� .,.. .� .� ��. �� � y;.•• Vis° <br /> CONTRACT PRICE OF WORK: $ 486.00 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES El NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install a new welding receptacle a the Gunderson Garage <br /> JOB EC1817 <br /> .. .,,,rG,�Fs.,,....v> .;.-,. e .. _ .,... ..a..�'�//da,.,, .�a�'!3'k�,�,..: ,® ,,a7•a �1�'�'oa��'��c �,,, .,.,x. .. '`�_-. _. _.., .., ,.. _,.-,.-. <br /> OWNER NAME: The Everett Clinic TENANT NAME(If Commercial): The Everett Clinic <br /> OWNER MAILING ADDRESS: STREET 3901 Hoyt Avenue <br /> CITY Everett STATE WA zo. 98201. <br /> OWNER PHONE: 425-259-0966 OWNER EMAIL: N/A <br /> CONTRACTOR NAME: Dutton Electric Company, Inc. <br /> CONTRACTOR ADDRESS: STREET 12407 Mukilteo Speedway, A-170 <br /> CITY J ynnwrrrwl STATE WA ztp 98087 <br /> CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAIL: info�?a duttonelectric.com <br /> CONTRACTOR LIC.#(REQUIRED): DUTTOEC137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):019811 <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Brad Morin CONTACT PHONE: 425-409-4854 <br /> CONTACT EMAIL: brad( duttonelectric.com <br /> AGREEMENT:T hereby certify that i 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 lam authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> 41 61o <br /> ial is tlauni <br /> PERMIT# <br /> PeitaSmit �OtI8,0e50a1taaegroyntltegritrythmE 1 T <br /> J � <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />