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Li�ECTRICAL PERMIT A�LICATION <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 <br /> � ���� x ����\ 'Y .... ,...<:� � .� ,..._�� \ -, �r- 3��v�� �' ��� <br /> r � . �...... �...� ,. � ��:�.. \ <br /> * <br /> �����. ,`���'�s#�3�„� ��. .. . , • £��\ � �� ��... � . � y� .��Ar�F�� <br /> --:<�.,. .k :1-.r.,.. <br /> PRo�ecra��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-23 Facto Shift Bell <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: I$�COMMERCIAL <br /> USE OF BUILDING: <br /> ���� ���.k �::.......�� ����.. '�' ��� �`, �:��\ �� :. ."s ������..... `'„�,., s:�'�5`i5�w��; � .-z. <br /> .�..y:._., ,.,-. <br /> CONTRACT PRICE OF WORK: $7,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 217442 - PPOVId2 ower to new facto shift bells <br /> ___�..,:: � <br /> f � : � ,,.��� <br /> : .� ,�. C; ��� <br /> :.. . . ........ ..... ._.� .a . <br /> . �. . <br /> . <br /> �� .. <br /> � -. , r� . <br /> �:. �,�, �� �.��..., <br /> OWNER NAME: BO@I11 COt11 an TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReeT PO Box 3707 MS 1 F 09 <br /> o�n Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTOR ADDRESS: srREer 901 Powell Ave SW Suite 100 <br /> ��n Renton STATE WA Z�P 98057 <br /> CONTRACTOR PHONE: ZOF>.437.63H'I CONTRACTOR EMAIL: SllallllOtl.f f0 rou .net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGC$C3LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44�j69 <br /> > .. . . ,. ,,. <br /> PRIMARY CONTACT: ❑OWNER I$�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2O6.6H3.ZO3. <br /> Miriam Saunders coNTacr ennai�: Miriam.S@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 laws and ordinances goveming 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 /> /ocal law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform fhe 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 Only <br /> FEE <br /> ����° <br /> ' signed by Shannon Fuller PERMIT# <br /> � US,E=Shannon.F@foygroup.net, <br /> F Group,OU=ProjectManager, C � /�0��./C��� <br /> F o Y c �� o u €� = annon Fuller C '� lJ <br /> � <br /> ELECTRICAL I SOL�R I CONTAOlB� � <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />