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11/Z3!2010 TUE 23:28 FAX 4251551610 dut:t:on canon <br />0002/002 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 95201 I I ' a4 0 <br />425-257-8810 - FAX 425-257-8357 — vnvw.everettwa.org C/o )) <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM lob EC10-DO <br />3901 110YT AVE <br />PROJFCTADDRESS <br />THE EVERETT CLINIC 3901 HOYTAVENUE EVERETT WA/98201 (425)259-0966 <br />Owner Mail Address City Slate/Zip Phone <br />SAME AS ABOVE <br />Tenant Mail Address City Stale/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 State/Zip Phone <br />DUTTOEC137P3 $3,629.51 <br />State License Number Contract Price of Work <br />Medical Office DAVEM (425)3594933 <br />Proposed Use of Building Contact Person (Plan Revic.V) <br />Description of Work to Be Done: Pathology Panel Replacement (Remodel) <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 end know the some to be true and <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 nresume to give euthorily to <br />violate or cancel the previsions of any other stafo or local low regulating construction or the <br />performance of construction. That I am authorized by the owneref this property to perform the <br />work for which application is made and I comply with the State Contractors Law 15.27 RCV'J and <br />296.2?�L.4Y.4 <br />11/24/2010 <br />Signature Date <br />