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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.govJpermits <br /> � � � ,� �y y� y�. �,�� � z�� � <br /> � �''� �c� � ��a'i��'������� � lS�����t :: ��i�� ��.���o ��, .y a� � <br /> ...�...: �\\�a....:: ...�::.���. . . . .::.... ...... .....'.�� ..:: .�+:.; .........^ ,,,,:, t:. „x, .:�..\i\� .�.. <br /> r <br /> PRo�ecra��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-22 Ocean Breeze D-11/12 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTf-FAMILY-#OF UNITS: IBI COMMERCIAL <br /> USE OF BUILDING: <br /> A�t��� Y r'+g. �'s .: �' �M ¢ ' � `, '� \��\ \ \ � <br /> � �:��C��+.��� .�� ��#�Y� � �'��Il�II����Tr%. \ \. `� x� \����1 <br /> . . �< �\�� . . <br /> .......:: . ........ . -.;. . ..... .... ...... .. �- .... .. .. ....�,...::.� ...... .._.. . . ,,, ..��-..� <br /> CONTRACT PRICE OF WORK: $8,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 2'I73O2 - OCeatl Bt'@@Z@ rovide and install rece tacles and disconnect <br /> switches <br /> �. �� <br /> ; � � M ����� ��y ,� �.A � �MATl�����.. � <br /> OWNER NAME: BO@Itl COPTI an TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer PO Box 3707 MS 1 F 09 <br /> o�n Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTOR ADDRESS: srReer <br /> ��n Seattle STATE WA Z�P 98117 <br /> CONTRACTOR PHONE: ZO6.43T.63H� CONTRACTOR EMAIL: SIla11C1011.'F f0 rou .net <br /> coNTRacTOR uc.#�REQuiREo>: FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Ot44rj69 <br /> _ , .. . � �,. �.. . 4.... , �... . . <br /> PRIMARY CONTACT: ❑OWNER I$�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42rj.4.63.rj7]2 <br /> Aaron Mitchell coNTacr ennai�: Aaron.m@foygroup.net <br /> AGREEMENT.�T hereby certify that I have read and examined this application and know the same to be true and correcf. 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 pertormance of construction. That I am authorized by the owner of this property to pertorm 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 Onty <br /> FEE <br /> � 22� °� <br /> �; <br /> �I[y signed by Shannon Fuller PERMIT# <br /> ;; �� N. `US,E=Shannon.F@foygroup.net, <br /> F Group,OU=Project Manager, C 1� O � i� ( r <br /> c o f � tt a : N = ' annon Fuller � ���' � � <br /> �-w <br /> EIECTRICAt 1 SOLFR I CONTAOLS <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />