|
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@everetfinra.gov� www.everettwa.gov/permits
<br /> ,�:�,����-��� �� ���; �: � �
<br /> ��;���_������ � ��� -
<br /> �� .�,. .....,,.. �����s...� �; z,�a. ..>..� � ,r:�. \ � ��
<br /> PRo�ecT ao�Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-22 Cafeteria Ovens
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF
<br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATfACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �$I COMMERCIAL
<br /> USE OF BUILDING:
<br /> � ,� : ,�
<br /> .:., � �=- t , ,.. �, r
<br /> ..�:u .., -; -- .
<br /> ...::.. ,� .. .,,•,,,,,"•r�� , ., y,... ... :.. . ...
<br /> CONTRACT PRICE OF WO : $10,000
<br /> NUMBER OF DEVICES if lo volta e :
<br /> FIRE ALARM? ❑YE O
<br /> ASSOCIATED BUILDING PERMIT# if a licable :
<br /> DESCRIPTION OF WORK: 17-0527 - Provide a new anel and two oven rece tacles
<br /> '� ��ti�- � ,��, �- � yii f y .- ,r � j �
<br /> � ,.a!�f "` :p�. ,� �.' a v.<�.w� ���� , G:, �t .����«, .��, e,�.�y/,
<br /> OWNER NAME: BO@ICl COI'Tl an TENANT NAME If Commercial):
<br /> OWNER MAILING ADDRESS: s-rReer 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: sTReer
<br /> ��n Seattle STATE WA Z�P 98117
<br /> CONTRACTOR PHONE: ZO6.437.63H'I CONTRACTOR EMAIL:�Sllallt1011.f f0 rou .net
<br /> CONTRACTOR LIC.#(RE(2UIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O4t�56Q
<br /> . . � ., r. ., � � ,.. , . .�,
<br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 42rj.463.�j772
<br /> Aaron Mitchell coNTacT eMai�: Aaron.m@foygroup.net
<br /> AGREEMENT.•T hereby certify that 1 have read and examined this application and know the same to be frue and correck All provisions of laws and ordinances governing this
<br /> rype of work will be comp/eted whether specified herein or not. The granting of a permit does not presume to give authority to vio/ate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That/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?8.27 RCW and 296.200 W,4C.
<br /> City of Everett Official Use Only
<br /> FEE
<br /> �SO �
<br /> signed by Shannon Fuller PERMIT#
<br /> � US,E=Shannon.F�foygroup.net, //......»»
<br /> F' �Group,OU=Project Manager, C ��� O ` t �`�
<br /> F o v G rs o u a �\ = annon Fuller � t
<br /> EIECTRICAt � 80L�R I CONTROtB��:+:'�'��a�.�.. -
<br /> Owner/AuthorizecJ Agent Signature Date (Revised 10/12/2015)
<br />
|