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10/21/2015 WED 9: 12 FAX 4253551610 dutton canon lI002/002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 1506 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 1800 41ST STREET <br /> PROJECT ADDRESS <br /> THE EVERETT CLINIC 3901 HOYT AVE EVERETT WA/98201 (425)259-0966 <br /> Owner Mail Address City State/Zip Phone <br /> SAME AS ABOVE <br /> Tenant Mail Address City State/Zip Phone <br /> Dutton Electric Company. Inc. 12407 Mukilteo Speedway, A-170,Lynnwood WA/980 7 (425)347-7600 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> DUTTOEC137P3 019811 <br /> State License Number(required) City of Everett Business License Number(required) <br /> BUSINESS OFFICES $67,500.00 <br /> Proposed Use of Building Contract Price of Work <br /> Dave McLaughlin (425) 359-4933 <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Tenant Improvement <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 J o 0 <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E (5( D- o <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and t V/ <br /> 296.200 WAe. <br /> 14021 <br /> /: 10/21/2015 <br /> ignature Date <br /> REVISED 08/06/2014 <br />