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/OP ELECTRICAL PERMIT AI .ICATION <br /> ;./ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ( (E)everetteps@everettwa.gov ( www.everettwa.gov/permits <br /> litw.:ry ate. <br /> s, <br /> a 4. <br /> •�.:a z >�,,�, AFS <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 /> itiler• ' ���� *�' ..� - ., .a was .rec��,the f_3'..<..�*� <br /> CONTRACT PRICE OF WORK: $ 585.73 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ID NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: TEC Gunderson Garage Dedicated Receptacles <br /> JOB EC1818 <br /> ..,.-- <br /> O TACT O aTiON alr � Oi <br /> 3. _ p F., �a t� r.-c s is � �� <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 ZIP 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. A470 <br /> CITY Lynnwood STATE WA ZIP 98087 <br /> CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAiL: info@duttonelectric.com <br /> CONTRACTOR LIC.#(REQUIRED): DUTTOEC 137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):0 19811 <br /> PRIMARY CONTACT: ❑OWNER 4 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Brad Morin CONTACT PHONE: 4254094854 <br /> CONTACT EMAIL: brad(17,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 i am 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 /> (00 .°6 <br /> a.at , signed by Peita Smith <br /> •N US.E=peita@duttonelectric.com, PERMIT# <br /> P e i fia a m i � 0-DECO,CN=Pelta Smith <br /> a :I attest tto the accuracy and integrity E \ b -000'7 <br /> ocumen <br /> S. -.,;Q18.06.0811.22.38-07'00' <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />