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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 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3003 West Casino Road, Everett, WA 98203 Building 216417 - 40-41 Lab Expansion <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: CK COMMERCIAL <br /> [USEOF BUILDING: <br /> EL CTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:'''$8,000 <br /> NUMBER OF DEVICES if low vo <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 216417 - Provide support demo and receptacles for wall move <br /> CONTACT INFORMATION <br /> OWNER NAME: Boeing Company TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTREET PO Box 3707 MS 1 F 09 <br /> ciTV Seattle STATE WA ZAP 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Foy Group <br /> CONTRACTOR ADDRESS: STREET 2400 NW 80TH ST Su Ote 118 <br /> cTy Seattle STATE WA zip 98117_ <br /> CONTRACTOR PHONE: 206.437.6381 CONTRACTOR EMAIL: Shan non.f f0 rou .net , <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 44569; <br /> PRIMARY CONTACT: ❑OWNER ®CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425.4.63.5772 <br /> Aaron Mitchell CONTACT EMAIL: Aaron.m@foygroup.net <br /> AGREEMENT:Thereby certify that/have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing 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/am authorized by the owner of this property to perform the work for which application is made and 1 <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 /> igitally signed by Shannon Fuller PERMIT# <br /> DN:Q=US,E=Shannon.F@foygroup.net, <br /> CNFoy Group,OU=Project Manager, C <br /> r o v €; R 13 L f 1'" <br /> CN=Sgannon Fuller C <br /> ELECTRICAL I SOLAR I CONTROLS Date:2016.02.2208:59:11-08'00' <br /> Owner/Authorized Agent Signature Date (Revised 10/1212015) <br />