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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.govlpermits <br /> , ;... , ��. <br /> , <br /> . <br /> :. ;� <br /> � , . <br /> ,...sv .:,,�_,_.;.. � v���...:. _.� � . <br /> , , ��.. <br /> PRo�ecr ao�Ress: 3003 West Casino Road Everett WA 98203 Buildin 21642 -40-22 RF Antenna <br /> BUILDING AREA(if residential, new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATl'ACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �GOMMERCIAL <br /> USE OF BUILDING: <br /> a ��4� � : <br /> �:'�,�r�� <br /> CONTRACT PRICE OF WORK $4,000 <br /> NUMBER OF DEVICES if low Ita e • <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 216420 -40-22 RF Atltetllla rovide su ort to install Antenna <br /> ,� �_:: . � . F... , , __ � ��°��' z <br /> . <br /> ��\� r's. M��3x�x ..$"�s+ .RY>'� ,�,��f� F �1�," <br /> OWNER NAME: g021f1 C01'Tl all 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 /> coNTRacroR PHONe: 206.437.6381 CONTRACTOR EMAIL: SllaCltlOn.'f f0 rou .net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGCH63LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 04.4�j69 <br /> v s . � v _. _ „.. ,_._.., _ . <br /> PRIMARY CONTACT: ❑OWNER ($I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4.2rj.4,63.�j772 <br /> Aaron Mitchell coNTacT eMai�: 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 correct. All provisions of/aws 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 violate or cance/the provisions of any other state or <br /> local law regulating construction or the perfoimance of construction. That/am authorized by the owner of this property to pertorm the work for which applicafion is made and 1 <br /> comply with the State Contracfors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> l �c ` <br /> signed by Shannon Fuller PERMIT# <br /> • US,E=Shannon.F�foygroup.net, � � ��� � �� r <br /> F Group,OU=Project Manager, `_ � <br /> F o v � � o u a = annon Fuller ( <br /> EtECTRICAL � SOLAR I CONT&OLS <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />