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ELECTRICAL PERMIT APPLICATION <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 /> � . .,��,:-: .�.� :� ��` �0������,�,�"� . .:. . .. Fi�: �rxr. � <br /> r�" � ,� .;z 3��a�� �, \ �, . �-' ��� r z�•�. <br /> �.::.. .::..-- .....,,..,, s�::...,.,... ..z.::... . � . . r ..0. . <br /> ..:�.: .�:::.....` ., .,. '�..K, . ...: ....� .�.::: <br /> PRo�ec-r A��REss: 3003 West Casino Road Everett WA 98203 Buildin 40-34 Servin Line <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: I$I COMMERCIAL <br /> USE OF BUILDING: <br /> '� `. .,.. `� . <br /> CONTRACT PRICE OF WORK: �11,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 17-0935 -40-34 Servin Line rovide e ui ment connections for new <br /> serving line equipment <br /> .� � <br /> "� A 'yy� .�' � � ���,,. ?,r< ������ � r .< ��, � aa <br /> g��s�„ � �„�� rt, <br /> OWNER NAME: 6081f1 COtYt an TENANT NAME If Commercial : <br /> OWNER MAILING ADDRESS: srReeT PO Box 3707 MS 1 F 09 <br /> o�n Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTOR ADDRESS: srRee-r <br /> ��n Seattle STATE WA Z�P 98117 <br /> CONTRACTOR PHONE: ZO6.437.635'I CONTRACTOR EMAIL: Sllafll1011.f f0 rou .net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGCH63LK CITY OF EVERETT BUSINESS LIC.#(REG2UIRED): O44.rj69 <br /> . ,. <br /> PRIMARY CONTACT: ❑OWNER I$�CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: t42rj.463.rj772 <br /> Aaron Mitchell coNrAcr ennai�: Aaron.m@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/aws and ordinances governing this <br /> type of work will be comp/eted whether spec�ed herein or not. The granting of a permft dces not presume to give authority to vio/ate or cance/the provisions of any other state or <br /> local law regulating construction or the performance oi construction. That/am authorized by the owner of this prUperty to perform the 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 Officia/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 �� �� � ��� <br /> F o v [; a n u a = annon Fuller C <br /> EtECTRICAI � SOLAR I CONTNOLS <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />