|
�ECTRICAL 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@everettwa.gov � www.everettwa.gov/permits
<br /> � �`�2�,✓q,� x �\��� ;_ �, ,��, ' � `��;��`. a �,��i.. �� �`� � \G,,�.�.
<br /> . �y\�..\\�:.�.-::..� .. .��:......\� �• .�:::• . ....�.�. .,.,..>. ;'�. .�^;::.�s ��.s-:,.. ' :.'�'
<br /> PRo�ecT a��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-34 Freezer
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF
<br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: BI COMMERCIAL
<br /> USE OF BUILDING:
<br /> �� ,� �� .: ,3 �> n= x y� ��
<br /> :�.
<br /> �. '� � � , s � �� �.: �
<br /> ��, -�:. ,?.....�v?�;��.�'�« .� �...�.�.a......,.... ..;._a�3. .,.a..��.:� ...,a. ....�.'�� " ..... �� i. ...�.:� .�a�...., r- �::. ...
<br /> CONTRACT PRICE OF WORK: $5,000
<br /> NUMBER OF DEVICES if low volta e :
<br /> FIRE ALARM? ❑YES ❑NO
<br /> ASSOCIATED BUILDING PERMIT# if a licabie :
<br /> DESCRIPTION OF WORK: 217477 - Provide electrical su ort of freezer install
<br /> , .r �
<br /> .� �.a�r,1 ,� � � �
<br /> ,f%!A;' � z i ,� �"�;, � �-, T�i����� �'yn �„y,� ,yi���G ���'�j' a ,��
<br /> 5
<br /> � ,,,__ _ ,, ,., : .
<br /> s� ,�,i1,H �,i
<br /> OWNER NAME: BO@I11 COI'Tl an TENANT NAME(If Commercial :
<br /> OWNER MAILING ADDRESS: s-rReer PO Box 3707 MS 1 F 09
<br /> ��n Seattle STATE WA Z�P 98124
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: FO GPOU
<br /> CONTRACTORADDRESS: srReer 901 Powell Ave SW Suite 100
<br /> ��n Renton STATE WA Z,P 98057
<br /> CONTRACTOR PHONE: ZO6.437.638'I CONTRACTOR EMAIL: SllaCll1011.f f0 rou .net
<br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGCH63LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44rj69
<br /> .,. ., �, ,, ...._. .. _ .
<br /> PRIMARY CONTACT: ❑OWNER I$�CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 42rj.4,63.�j']72
<br /> Aaron Mitchell coNracT eMai�: Aaron.m@foygroup.net
<br /> AGREEMENT.�T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this
<br /> (ype of work will be completed whether specified herein or not. The granting of a permif does not presume to give aufhority fo violate or cancel the provisions of any other sfate or
<br /> /ocal law regulating construction or the performance of construction. That/am authorized by the owner of this prope�ty 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=Project Manager, C \ x� � � �
<br /> F o v c � u :� a �` N- annon Fuller C � C�
<br /> ELECTRICAL � SOI�R I CUNTROtS�016.02.2208:59:11-OS'00�
<br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015)
<br />
|