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�LECTRICAL 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.everettwa.gov/permits <br /> .. f <br /> X <br /> .�Z e �.Z��:..� �\� � . . <br /> `�� .... \ ���.� : �\� ���. ..�v� � .;,"..:1� .Z.,y ��� ����. ��z;; �� ��� <br /> `. ...:. .,�. _ <br /> ,,. � . �.. . ... . ..�::.. � ,,. � ... ,.a .. _ :�. :'a� • <br /> PRo�ecT Ao�Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-22 Cafe Monitors <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATfACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: I�I COMMERCIAL <br /> USE OF BUILDING: <br /> � <br /> ��'� � �� � � ' ��3� � :: <br /> :. <br /> a.: <br /> ,F. <br /> :: <br /> , . � �, �a �� � <br /> �. „ , „..�r, ., W z � <br /> � <br /> CONTRACT PRICE OF WORK: $9,000 <br /> NUMBER OF DEVICES if low volta e : ' <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 217431 - Provide ower for 4 new monitors <br /> ,� ...�. '�w��� -, ��\� ;, F yt�r � :z ��'✓.,��#� � ��� :�' ,_,u,W;� a..:. <br /> �s t ii � � <br /> OWNER NAME: BOeltl COCTI an TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReer 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: s-rReer <br /> ��n Seattle STATE WA Z�P 98117 <br /> CONTRACTOR PHONE: ZO6.437.F)3S� CONTRACTOR EMAIL: Sl1aftflOfl.'F f0 rou .net <br /> coNTRacTOR�ic.#�REQu�REo�: FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O4t�rj69 <br /> ....�.,�. . ,.,. ....... v . .. ,, . ...... <br /> PRIMARY CONTACT: ❑OWNER IR]CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42rj.4,fj3.�j]72 <br /> Aaron Mitchell coN-racT 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 specified herein or not. The granting of a permit dces not presume to give authority to vio/ate or cancel the provisions of any other stafe or <br /> /oca/law regulating construction or fhe performance of construction. That I am aufhorized by the owner of this property to perform the work for which applicafion 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 /> � 2��� <br /> signed by Shannon Fuller PERMIT# <br /> � US,E=Shannon.F@foygroup.net, �� <br /> F Group,OU=Projeet Manager, r �� � <br /> F n r c a u u u = annon Fuller C <br /> ;�3r. <br /> EIECTRICAt I SOLAR � COMTROL% � <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />