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03/31/2015 TUE 10:16 FAX 4253551610 dutton canon <br />� <br />EC 15-U <br />• <br />ELECTRICAL PERMIT APP�ICATION <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 />3927 RUCKER AVE (Kemp Surgery 1 st Floor) <br />PROJECZ ADDRESS <br />THE EVERETT CLINIC 3901 HOYT AVE <br />Own e r <br />SAME AS ABOVE <br />Tenant <br />Mail Address <br />Mail Address <br />EVERETT <br />City <br />City <br />f�ooz/ooz <br />WA/98201 (425)259-0966 <br />State/Zip Phone <br />State/Zip <br />Phone <br />Dutton Electric Company Inc 12407 Mukilteo Speedway A-170 Lynnwood WA/980$7 (425)347-7600 <br />Electrical Confractor Maii Address City State/Zip Phone <br />�?UTTOEC137P3 <br />State License Number (required) <br />MEDlCAL <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (If low voltage) <br />019811 <br />City of Everett Business License Number (required) <br />$329.00 <br />Contract Price of Work <br />Brad Morin (425) 409-4854 <br />Contact Person/Contact Number/Email <br />Description of Work to Be Done: CII"CUIt t0 SeCUI'Ity POW@P SUppiy 011 til@ �5t f�001' <br />C}TY pF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 he�eby certify thaf 1 have read and examined this applicafion and know the same to be true and <br />co�rect. All p�ovisions of laws and ordinances governing this fype of work will be completed <br />whefher specified herein or not. The granfing of a permif does not presume fo give aufhority fo <br />violate or cancel fhe provisrons of any other state or local law �egulating constructron or the <br />performance of construction. Thaf l am authorized by the owner of this property to pertorm fhe <br />work for which application rs made and I comply with the State Coniraciors Law 18.27 RCW and <br />REVISED 0&06/1014 <br />FEE <br />PERMIT# <br />E .CS���-I� <br />