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03/23/2015 MON 8: 08 FAX 4253551610 dutton canon 0004/004 <br /> 0 0 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> EC15-B 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> 3901 HOYT AVE <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/98087 (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 /> MEDICAL $1,600.00 <br /> Proposed Use of Building Contract Price of Work <br /> Brad Morin (425) 409-4854 <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: ACC New Exam Rooms <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> l 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/am authorized by the owner of this property to perform the 150 3 17, <br /> work for which application is made and l comply with the State Contractors Law 98.27 RCW and Y <br /> 296.200 <br /> 7 <br /> `" 03/23/2015 <br /> igna ur Date <br /> REVISED Oai06/1014 <br />