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05/08/2011 SUN 22:04 PAX 4-153551610 dutton canon <br />m002/002 <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 — wwvi.everelty✓a.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Job EC11-IK <br />3901 Hoyt Ave <br />PROJECT ADDRESS <br />THE EVERETT CLINIC 3901 HOYT AVENUE EVERETT WA198201 (425)259-0966 <br />Owner Mail Address City Slate/Zip Phone <br />SAME AS ABOVE <br />Tenant Mail Address City State/Zip 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 Stale/Zip Phone <br />DUTTOEC137P3 $2,102.76 <br />State License Number Contract Price of Work <br />Sewage Litt Station _ DAVE M (425) 359-4933 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: Electrical Circuit to new lift station <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 <br />1 hereby certify that I have read and examined this application and know, the some to be true and <br />correot. 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 resume to give authority to <br />violate or cancel the pprovisions of any other state or local law regulaling construction or the <br />performance of construction. Thcf I am aulhonzed by the owner of this property to perform the <br />work for which application is made and; comply with the State Contractors Law 18.27 RCW and <br />296. . <br />5/9/2011 <br />It <br />I Q✓ CC <br />SignatW� "Ull <br />