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041'-0/2009 NON 11: 38 FAX 4253551610 Button canon <br />LJ001%001 <br />ELECTRICAL PERMIT APPLICATION <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3927 RUCKFR AVENUE <br />PROJECT ADDRESS <br />THE EVERETT CLINIC 3901 HOYT AVENUE EVERETT WA198201 (425)259-0966 <br />Owner Mall Address City StatelZip Phone <br />SAME AS ABOVE <br />Tenant Mail Address City StalelZip Phone <br />Fax:—(425)355-1610 <br />Dutton Electric Company 12407 Mukilteo Speedway A-170 Lynnwood, WA 98087 (425)347-7600 <br />Electrical Contractor Mail Address City State/Zip Phone <br />DUTTOEC137P3 $2,405.00 <br />State License Number Contract Price of Work <br />MEDICAL DAVEM (425)3594933 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of work to Be Done Add outlet & circuit -Add data raceway�Ct <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE $ <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />1 hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions oflaws 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 authorit y to <br />violate or cancel the provisions or any other state or local law regulating construction or the <br />perfo co ofconstruchon. That/ am authorized by the ownerorthis groporiy to perform the <br />vl or tv application is made and I comply with the State Confrectors Law 18.27 RCW and <br />r?96.200 WAC. <br />0 2 2009 n /n <br />Slgnal6 ate <br />�O <br />