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06/10/2010 WED 22:59 PAX 4253551610 dutton canon <br />QJ003/003 <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 A PM <br />lob HC10.135 Gunllcrson <br />3927 Rucker Avenue <br />PROJECT ADDRESS <br />THE EVERETT CLINIC 3901 HOYT AVENUE EVERETT WA/98201 (425)259.0966 <br />Owner Mail Address City State/Zip Phone <br />SAME AS ABOVE <br />Tenant Mail Address City Statel2lp Phone <br />Pax: (425)355-1610 <br />Dutton Electric Company 12407 Mukilteo Speedway A-170 Lynnwood, WA 98087 (425)347-7600 <br />Electrical Contractor Mail Address City Stale/Zip Phone <br />DUTTOEC137P3 $5,080.00 <br />State License Number Contract Price of Work <br />Parking Gal -age DAVEM (425)359-4933 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Llpll(ing Fixture Retrofit <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 3105 --11 <br />I hereby certify that I have read and examined ibis application and know the same to be true andZ-�- <br />correct. All provisions of laws and ordlnonces governing Ibis type of wodr will be completed <br />whether specified herein ornol. The gianting of a penntl does not presume to give authority to <br />violate or cancel the provisions of any other state or, local law rogulating construction or the <br />performance of construction. That I our authorized by the owner of ibis property to perform the <br />work f application is made and I comply with the Slate Contractors Law 16.27 RCW and <br />0 WAC. <br />8 18 2010 <br />Signature Oalc <br />