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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 <br /> F ,. <br /> . <br /> ����� �:�"a� <br /> , rz <br /> ,� <br /> _.,..� ;.�. ..<��.. � _ � �z: <br /> PRo�ecr ao�Ress:3003 West Casino Road Everett WA 98203 Buildin 40-54 Short Circuit <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: BI COMMERCIAL <br /> USE OF BUILDING: <br /> � z� �, , <br /> '� � '�^, _ ��*�� .�. <br /> n.��.<;� <br /> CONTRACT PRICE OF WORK: $24,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 21 7362 -40-54 R@ lace 2 anelboards <br /> „ � , <br /> �,,- , � <br /> � <br /> , ..,, �� ,� � < <br /> 'y/r;� ..,.\.���� .Cu...:� .r.,',��.. . ; \�\�a/ ��,� ', ,:: �� �;... "si� ; ��. <br /> //T F.. _,.3". ,,..T., <br /> OWNER NAME: BOeltl COtl1 an TENANT NAME If Commercial : <br /> OWNER MAILING ADDRESS: srReer PO Box 3707 MS 1 F 09 <br /> ��� Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTORADDRESS: sTReer 901 Powell Ave SW Suite 100 <br /> ��n Renton STATE WA Z,P 98057 <br /> CONTRACTOR PHONE: ZO6.437.63H'I CONTRACTOR EMAIL: Sllalll1011.f f0 rou .net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGCH63LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44rj6J <br /> . .... ..�... . _ ..., .. <br /> PRIMARY CONTACT: ❑OWNER �I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4,2rj.463.rj772 <br /> Aaron Mitchell coNracT ennai�: Aaron.m@foygroup.net <br /> AGREEMENT.•T hereby certify thaf 1 have read and examined this application and know the same to be true and correct. All provisions of/aws and ordinances goveming fhis <br /> type of work will be completed whether specified 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 /> . local law regu/ating construction or the performance of construction. That/am aufhorized by the owner of this property to pertorm the work for which applicafion is made and f <br /> comp/y with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Officia/Use On/y <br /> FEE <br /> ��� �— <br /> signed by Shannon Fuller PERMIT# <br /> � US,E=Shannon.F@foygroup.net, <br /> F Group,OU=Project Manager, C t �r n � ` l <br /> e o r �; e u u a = annon Fuller C � \ L � � <br /> EtECTRICAL � SOL�R I CUXiROt8 � . <br /> Owner/Authorizetl Agent Signature Date (Revised 10/12/2015) <br />