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01-'17 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 l FAX 425-257-8857 1 (E)everetteps@everettwa.gov l www.evet'ettwa.gov/permits <br /> .. ,,,,.,,.., - .$7 EE NT INFQ �A �'t Via. <br /> PROJECT ADDRESS: 4004 Colby Ave (Dermatology) <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 Bld&. <br /> CONTRACT PRICE OF WORK: $ 1,677.00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES El NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Vj I Vv `� Dl W <br /> DESCRIPTION OF WORK: Extending a lighting circuit at Dermatology <br /> JOB EC1832 <br /> n. H <br /> OWNER NAME: Thp Eyeiejt Clirtjc TENANT DAME(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. A-170 <br /> CITY I.ynnwnnrl STATE WA ZIP 98087 <br /> CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAIL: info@duttonelectric, ojn <br /> CONTRACTOR LIC.#(REQUIRED) DUTTOEC137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):019811 <br /> PRIMARY CONTACT: ❑OWNER in CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Brad Morin CONTACT PHONE: 425-409-4854 <br /> CONTACT EMAIL: braddtx duttonelectric.coni <br /> AGREEMENT:T hereby certify that I have mad 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 /> Wilt**signed by Peita Smith <br /> ® • DN G US,E=pelta@duttonelectric.com, PERMIT# <br /> Peita Smi ECO,CN=Pella Smith i1`��f!°1�/r��/s�I <br /> flaatieV:1=apttest to the accuracy and integrity E l V�-�° I-y l U <br /> of t , cument <br /> Date"2018 09.21 09'17:14-07'OQ' <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />