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ELECTRICAL PERMIT PLICATION <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 /> ;M ��� ; <br /> �:-.e,� ..,; <br /> PRo�ecra��Ress: 3003 West Casino Road Everett WA 98203 Buildin 40-34 J12.5 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: I$I COMMERCIAL <br /> USE OF BUILDING: <br /> � � <br /> � " ��. :: <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: 217323 - Inline Su ort Provide rece tacles <br /> l�IA� �4 �. . ±"�� '.'..�„ . .": +.. ...:.. �' � " � -�f . . <br /> ���� . �� . ,. ,.._.«- �:� «... �., , ..f:, - '��. ` � ��.���i,�.� �,_£�da�° ��,�'��: <br /> .�'�,�;�v _v�a.,.�' :�"#=� �^x <br /> OWNER NAME: BO@Itl COt71 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 /> CONTRACTOR ADDRESS: sTReer <br /> ��n Seattle STATE WA Z�P 981�7 <br /> CONTRACTOR PHONE: ZO6.43T.63S'I CONTRACTOR EMAIL: SllaCltlOtl.f f0 rou .net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 044.�j69 <br /> PRIMARY CONTACT: ❑OWNER I�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4Z�'J.463.S77Z <br /> Aaron Mitchell coNTacT ennai�: Aaron.m@foygroup.net <br /> AGREEMENT.-T hereby ce�tify that I have read and examined this application and know the same to be true and correcf. A!l provisions of/aws and ordinances goveming this <br /> type of work will be comp/eted whether spec�ed herein or not. The granting of a permit does not presume to give authority to vio/ate or cance/the provisions of any other state or <br /> /oca/law regu/ating construction or the performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and! <br /> comp/y with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Onty <br /> FEE <br /> � ; n�, � <br /> V� .�— <br /> signed by Shannon Fuller PERMIT# <br /> • US,E=Shannon.F@foygroup.net, �/�'� <br /> F Group,OU=Project Manager, C I� E Y�p(^ y�/� � <br /> F o r s e u u a = annon Fuller G � 17`� L�1 n <br /> ••V lJ�_IG <br /> ELECTRICAt � SULl�R I C�XTROlB <br /> Owner/Authorizetl Agent Signature Date (Revised 10/12/2015) <br />