3003 W CASINO RD BLDG 40-34 2019-01-11

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everetfinra.gov� www.everettwa.gov/permits �� . � �� `��'�, ,:,,.. :, ��5w; .. ...e = , �,,�<:��.. ......;S��M . �, � ,� � , .: r.. . ,: � � � , , , �... � . ..t:. � �:� . .....:::. PRo�ecT a��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-34 BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �I COMMERCIAL USE OF BUILDING: ,,� �, ; � � � �� t � ',l.''• �v •�� '.l � L'..�.i��,, r��?..v%Y�.'�.��`�Fn,',, CONTRACT PRICE OF WORK: $3,000 NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: 21 8066 -40-34 CHCA Machine installin 'outlet and new homerun � s a �� 4/.� ��' ..��, �ax. ...�� ' ;� ..y,f OWNER NAME: BOeICI COPYt an TENANT NAME If Commercial : OWNER MAILING ADDRESS: srReeT PO Box 3707 MS 1 F 09 ��n Seattle STATE WA Z�P 98124 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: FO GCOU '' CONTRACTORADDRESS: srReeT g01 Powell Ave SW Suite 100 ��n Renton STATE WA Z,P 98057 CONTRACTOR PHONE: ZO6.43T.638� CONTRACTOR EMAIL: SI18t1nOCl.f f0 rou .net coNrRacTOR�ic.#�REQuiREo�: FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44rj6Q . w. �. . _ . PRIMARY CONTACT: ❑OWNER ($)CONTRACTOR ❑OTHER(Please Specify) ' CONTACT NAME: CONTACT PHONE: 425.t�63.rj772 Aaron Mitchell coNracT eMai�: Aaron.m@foygroup.net AGREEMENT.�T hereby cerfify fhat 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this lype of work will be completed whether specified herein or not. The granting of a permif does not presume to give authority to vio/ate or cancel fhe provisions of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property fo perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. ' City of Everett Official Use Only ' FEE �32 - SO signed by Shannon Fuller PERMIT# � US,E=Shannon.F@foygroup.net, �'� `F Group,OU=Project Manager, F o Y G � � � N = annon Fuller , E 1 $02,w 1 � � ELECTRICAL I $��aR � CONTROLS ��, Owner/Authorizetl Agent Signature Date ' (Revised 10/12/2015)