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�LECTRICAL 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 /> . .. ..��w .:� -����..:.. < � . ::.�� � ti�� �-k.� <br /> � �. <br /> a <br /> - -�.,�: .. . ....'u . .. ... ��.:, w .. �'\. ;.. ......,.. :�..� ::;: �.r.s., � <br /> :x;,, a�, ..-• ..., ... <br /> ___ k� .� v _ . ___._ <br /> PRo�ecr,a��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-26 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: IBI COMMERCIAL <br /> USE OF BUILDING: <br /> , r. � .. .. .�� F' <br /> ���� s� ��t�; � �a,� y <br /> � .....:.�< .. . ..`. . ...... ... . ,� �.�......�� ,,. �. .:. �� ' ..,n.�.u�:...�.. \��i:. ���, <br /> CONTRACT PRICE OF WORK: $6,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? �YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 217442 - PC'OVId@ ower to new facto shift bells <br /> , � � .� � � .:..,. ., � E �.��� <br /> , _ <, ��t ��Y� <br /> � - , ��N��� �� _� <br /> �,;,,,,.!!!�_.� �.?��.... �...,: --_ _.�_3, <br /> � <br /> OWNER NAME: BOeICI C0171 an TENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS: srReer PO Box 3707 MS 1 F 09 <br /> ��n Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTORADDRESS: sTReeT g01 Powell Ave SW Suite 100 <br /> ��n Renton STATE WA Z�P 98057 <br /> CONTRACTOR PHONE: ZO6.437.63H� CONTRACTOR EMAIL: Sllat1C10C1.f f0 rou .net <br /> coNTRacTOR�ic.#�REQu�REo�: FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Ot�4rj69 <br /> �.. .__ T.__. ... . .. ......... ...,... ... <br /> PRIMARY CONTACT: ❑OWNER I$�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2O6.6H3.ZO3. <br /> Miriam Saunders coNr,acT 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 /> local law regulating construction or the performance of construction. That I 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 18.27 RCW and 296.200 W,4C. <br /> City of Everett Official Use Only <br /> FEE <br /> � � � D � � <br /> '� ���it� signed by Shannon Fuller PERMIT# <br /> � US,E=Shannon.F@foygroup.net, <br /> � ��F 'Group,OU=Project Manager, C ��� /�_,� <br /> F p v c n a u i� C�1= annon Fuller C �� <br /> ELECTRICAI � SOI�R I COXTROLS� <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />