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06/01/2009 NON 14:27 FAX 4253551610 dutton canon <br />0001/001 <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.ora <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3927 Rucker Avenue <br />PROJECT ADDRESS <br />THE EVERETT CLINIC 3901 HOYT AVENUE EVERETT WA198201 (425)259-0966 <br />Owner Mail Address City Stale/bp Phone <br />SAME AS ABOVE <br />Tenant Mail Address City Stale/Zlp Phone <br />Pax: (425)355-1610 <br />Dutton Electric Company 12407 Mukilteo Speedway, A-170 Lynnwood WA 98067 (425)347-7600 <br />Flectrical Contractor Mail Address City State/Zip Phone <br />DUTTOEC137P3 $25,130.54 <br />State License Number Contract Price of Work <br />MEDICAL DAVE M (425) 359-4933 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: (2) New Boiler Reeds & Sterile Storage <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 ! h <br />1 hereby certify that I have read and examined this application and know the same to be true and 4— O q o (j — Ov (<., <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 <br />violate or cancel the provisions of any other state orlocal law regulating construction or the <br />performance of construction. That/ am authorized by the owner of this propelty to perform the <br />work for which application is made and I comply with the State Contractors Low 18.27 RCW and <br />29681(3011 <br />L.. <br />DG �l 2W <br />Si...... Vale <br />VOW; <br />