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OLECTRICAL PERMIT AI61LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3003 W. Casino Rd Everett, WA. Bldg. 40-88 Multi-Function Room <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF y <br /> BUILDING TYPE: El SFR-DETACHED 11SFR-ATTACHED ❑ DUPLEX 11MULTI-FAMILY-#OF UNITS: L'f COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): Less then 70 Devices <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> Install new cables for news lit unit AC unit <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Company TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO Box 3707 MS 1 F 09 <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Foy Group <br /> CONTRACTOR ADDRESS: STREET 2400 NW 80TH ST Suite 118 <br /> CIN STATE ZIP <br /> CONTRACTOR PHONE: 206-743-2444 CONTRACTOR EMAIL: andi.r@foygroup.net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044569 <br /> PRIMARY CONTACT: ❑ OWNER LXCONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 206-743-2444 <br /> Wylie Hubbard CONTACT EMAIL: wylle.h@foygroup.net <br /> AGREEMENT.'Thereby certify that I 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 /> 00 <br /> Digitally signed by Wylie M.Hubbard PERMIT# <br /> Wylie M. Hubbard O=Foy Group, <br /> C i=Wy1je M. <br /> u boar 12/19/16 I r/_ <br /> DateGroup,12 1 Wylie M.HubbardI I n I 1� V 1 <br /> Date:2016.12.1214:19:37-08'00' l �(/ I� �/ <br /> Owner/Authorized Agent Signature Date (Revised 10/1212015) <br />