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LCTRICAL PERMIT APFCATION <br /> I�►�, CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov l www.everettwagov/permits <br /> ?uta H fv <br /> PROJECT ADDRESS: 1303 Pacific Ave (Spine Center) <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: 12i COMMERCIAL <br /> USE OF BUILDING: Medical Bldg. <br /> �E r � fi A�,�p J1.4 <br /> .o� r sow }�•o'x'Q n e� ��`vz <br /> AP 'i Mlle*I* 3 <br /> .mow Fx,�,� ._-. s '. <br /> CONTRACT PRICE OF WORK: $ 4 75.27 <br /> NUMBER OF DEVICES(if low voltaic): <br /> FIRE ALARM? 0 YES <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Extending a circuit and adding an outlet at the Spine Center <br /> JOB EC1824 <br /> } <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 zlp 98201 <br /> OWNER PHONE: 425-259-Q966 OWNER EMAIL: N/A <br /> CONTRACTOR NAME: Dutton Ele uric Company.Inc. <br /> CONTRACTOR ADDRESS: STREET 12407 Mukilteo Speedway. A-170 <br /> CITY Lynnwood STATE wA zip 98087 <br /> CONTRACTOR PHONE:(425) 347-7600 CONTRACTOR EMAIL: infot7a duttonelectric.com <br /> CONTRACTOR LIC.#(REQUIRED): DUTTOEC137P3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 019$11 <br /> PRIMARY CONTACT: 0 OWNER ®CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: Brad Morin CONTACT PHONE: 425-409-4854 <br /> CONTACT EMAIL: brad(u}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/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 /> S3 • c <br /> p't. ly signed by Peita Smith <br /> Peita WJS,E=peita@duttonelectrio.com, PERMIT# <br /> rJ=DECO,CN=Pelta Smith <br /> Smithw.i attest to the accuracy and integrity C 1 SO r - l <br /> �, V SCJ <br /> :.,!,...„.,,,‘,14-4'.‘4.7;4%10:02.59-07'00' <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />