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�ECTRICAL PERMIT AP ICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everetfinra.gov� www.everetfinra.gov/permits
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<br /> PRo�ecra��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-03 Cubicle Demo/Install
<br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF
<br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: L$I COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF WORK: $2,000
<br /> NUMBER OF DEVICES if low volta e :
<br /> FIRE ALARM? ❑YES ❑ NO
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
<br /> DESCRIPTION OF WORK: 21 7465 -40-03 Cubicle Demo/Install
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<br /> OWNER NAME: BO@Itl COPYI an TENANT NAME(If Commercial :
<br /> OWNER MAILING ADDRESS: sTReer PO Box 3707 MS 1 F 09
<br /> ��N Seattle STATE WA Z�P 98124
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: FO Grou
<br /> CONTRACTOR ADDRESS: srReer
<br /> ��n Seattle STATE WA Z�P 98117
<br /> CONTRACTOR PHONE: ZO6.437.63$'I CONTRACTOR EMAIL: Sllatll1011.f f0 rou .net
<br /> coNTRacTOR�ic.#�REQuiREo�: FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44rj69
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<br /> PRIMARY CONTACT: ❑OWNER I$�CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: t�2rj.463.rj]]2
<br /> Aaron Mitchell coNrac-r ennai�: Aaron.m@foygroup.net
<br /> AGREEMENT.�T hereby certify that l have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this
<br /> type of work will be completed whether spec�ed herein or not. The granting of a permit does not presume to give authority to violafe or cancel the provisions of any other sfafe or
<br /> local law regulating consfruction or fhe performance of construction. That 1 am authorized by the owner of this property to pertorm the work for which application is made and I
<br /> comply with the Sfafe Contractors Law 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE
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<br /> signed by Shannon Fuller PERMIT# ' !
<br /> : US,E=Shannon.F@foygroup.net, ���
<br /> r F Group,OU=Project Manager, (
<br /> F o v � � u u �� �'� annon Fuller � ��� "� l
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<br /> EIECTRICAI � SOLAR I GONtROIS���.^.�a�..s:�r:��*•
<br /> Owner/Authorizetl Agent Signature Date (Revised 10/12/2015)
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