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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 /> �,��� - � ,;. �� <br /> �� � �:r <br /> �. , <br /> ,. : � <br /> , l�� a '�� �.;`_ .�a x �\,a.. a� �� <br /> PRo�ecT a�oRess: 3003 West Casino Road Everett WA 98203 Buildin 45-80 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 /> •'\.• ''•� S,n�'.� �.. �. .Y:�'Y� S���:4� <br /> CONTRACT PRICE OF WORK: $12,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 17-1046 - 45-80 Servin Line rovide e ui ment connections for new <br /> serving line equipment <br /> � � ��� �. �s <br /> ,,. <br /> `aY�'i:�' \:p i�.'. � Fb u��d d'`,�y �; •.�:. <br /> OWNER NAME: BOG'lll COI'T1 al1 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTReer PO Box 3707 MS 1 F 09 <br /> ��TM Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTOR ADDRESS: sTReer <br /> ��n Seattle STATE WA Z�P 98117 <br /> CONTRACTOR PHONE: 206.437.6381 CONTRACTOR EMAIL: SI1aC1ClOtl.f f0 rou .net <br /> coNTRacTOR�ic.#�REQu�REo>: FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44�j69 <br /> �. . . ,,, ....... . . . ...., .,.. . <br /> PRIMARY CONTACT: ❑OWNER I�$I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 42�j.463.rj7]2 <br /> Aaron Mitchell coNTacT 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 goveming this <br /> type of work will be comp/eted whether specified herein or not. The granfing of a permit dces not presume to give authorify to violate or cance/the provisions of any other state or <br /> /oca/law regulating construction or the pertormance of consfruction. That/am authorized by the owner of this property 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 Official 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, r qq^ ///��� <br /> F o v � � a u u = annon Fuller � � A � � �" �/,�� <br /> l Af� <br /> EtECTRICAt I 80L�R �� CONTROIS <br /> Owner/Authorizetl Agent Signature Date (Revised 10/12/2015) <br />