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0011111P,,,— RECTRICAL PERMIT APRICATION
<br /> • CITY OF EVERETT PERMIT SERVICES
<br /> �r� 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: 3813 Rucker Ave(Facilities Office)
<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 Bldg.
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<br /> CONTRACT PRICE OF WORK: $ 258.00
<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? 0 YES III NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: adding one circuit for outlet
<br /> JOB EC1845
<br /> OWNER NAME: The Everett Clinic TENANT NAME(If Commercial): The Everett Clinic
<br /> OWNER MAILING ADDRESS: STREET 3901 Hoyt Avenue
<br /> CITY Everett STATE WA zia 98201
<br /> OWNER PHONE:, 425„:49..990,0,___,_ OWNER EMAIL: N/A
<br /> CONTRACTOR NAME: Dutton Electric Company, Inc.
<br /> CONTRACTOR ADDRESS: STREET 12407 Mukilteo Speedway. A-170
<br /> CITY T.ynnwncid STATE WA Zip 98087
<br /> CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAIL: info@duttonelectric.com
<br /> CONTRACTOR LIC.#(REQUIRED): DUTTOEC137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):019811
<br /> PRIMARY CONTACT: 0 OWNER =A CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: Brad Morin CONTACT PHONE: 425-409-4854
<br /> CONTACT EMAIL: brad@duttonelectric.com
<br /> AGREEMENT:T hereby certify that!have read 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 I am 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 /> 50 .2,-4
<br /> SmI ;. IIy signed by Peita Smith PERMIT#Peita2018.10.24 EkO - 2J.:22-0700'
<br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015)
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