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04/20/2016 WED 12: 40 FAX 4253551610 dutton canon U002/002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> EC16 F 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> 3901 HOYT AVE LOWER LEVEL <br /> PROJECT ADDRESS <br /> THE EVERETT CLINIC 3901 HOYT AVE EVERETT WA/98201 (425)259-0966 <br /> Owner Mail Address City State/Zip Phone <br /> SAME AS ABOVE <br /> Tenant Mail Address City State/Zip Phone <br /> Dutton Electric Company, Inc. 12407 Mukilteo Speedway, A-170,Lynnwood WA/98087 (425)347-7600 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> DUTTOFC137P3 019811 <br /> State License Number(required) City of Everett Business License Number(required) <br /> MEDICAL $2,580.00 <br /> Proposed Use of Building Contract Price of Work <br /> Brad Morin (425) 409-4854 <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: Urology Room Remodel <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the same 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 presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the t O� r2,1performance of construction. That I am authorized by the owner of this property to perform the E f` <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 <br /> 04/20/2016 <br /> Si. ature Date <br /> REVISED 06/06(2014 <br />