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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.everetfinra.gov/permits
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<br /> PRo�ecr,a�oRess: 3003 West Casino Road Everett WA 98203 Buildin 40-45 9 VSU's
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF
<br /> BUILDING TYPE: ❑SFR-DETACHED ❑ -ATfACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF RK: $70,000
<br /> NUMBER OF DEVICES if ow volta e :
<br /> FIRE ALARM? ❑Y ❑NO
<br /> ASSOCIATED BUILDING P IT# if a licable :
<br /> DESCRIPTION OF WORK: 217252 - Install 9 VSU's
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<br /> OWNER NAME: BO@I11 COtll all 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: srReer
<br /> ��n Seattle STATE WA Z�P 98117
<br /> CONTRACTOR PHONE: ZO6.437.635'I CONTRACTOR EMAIL: SIlaC1t10C1.f f0 rou .net
<br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGCS63LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44�j69
<br /> PRIMARY CONTACT: ❑OWNER I�CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 42rj.463.�j772
<br /> Aaron Mitchell coN-rncr ennai�: Aaron.m@foygroup.net
<br /> AGREEMENT.�T hereby certi(y that I have read and examined this application and know the same to be true and correct. All 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 dces not presume to give authority to vio/ate or cance/the provisions of any other state or
<br /> /ocal law regulafing 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 On/y
<br /> FEE
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<br /> signed by Shannon Fuller PERMIT#
<br /> • US,E=Shannon.F�foygroup.net,
<br /> F Group,OU=Project Manager, C ��� ( _ O��
<br /> F o x c a p � � = annon Fuller � `
<br /> EIECTRICAt I SUL�R 1 CONTROlB
<br /> Owner/Authorizetl Agent Signature Date (Revised 10/12/2015)
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