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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@everetfinra.gov� www.everettwa.gov/permits <br /> �� � � �r� � � �� � <, ��� �� ���,����;��� � <br /> . � �._ <br /> ��..�.����r �.� ... . ........ <br /> ���� .. �:._�.-�.... . .... . �.• .. . _:.F. ....: a:•:�. ti '. ����,�..��`,.`��.-<:�. .? �. .� .��...�Z�`.. �. <br /> PRo�ecT a�oRess: 3003 West Casino Road Everett WA 98203 Buildin 40-45 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: R�COMMERCIAL <br /> USE OF BUILDING: <br /> �� ,��\��� �k� ,•.;. <br /> � � ��z ��, p� � <br /> ...\� ����'�..� � .��, ����� ��� 5 �X3:-.� <br /> CONTRACT PRICE OF WORK: $2,000 <br /> NUMBER OF DEVICES if low volta e : <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: 217252 - Provide ower to 5 Scales <br /> '; %/.lj f,', . .,: i, . .;:` ����'��� <br /> ,� �"� i� �s;� ;���: <br /> f :. y ��. <br /> , <br /> .... ..., ,.. ... ..,. ' ��.�... ,,, .;: „ .,. ...., ., <br /> y � �, �, <br /> OWNER NAME: BO@IIl CO�'Yl a11 TENANT NAME(If Commercial : <br /> OWNER MAILING ADDRESS: srReer PO Box 3707 MS 1 F 09 <br /> ��N Seattle STATE WA Z�P 98124 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: FO Grou <br /> CONTRACTOR ADDRESS: srReeT <br /> o�n Seattle STATE WA Z�P 98117 <br /> CONTRACTOR PHONE: ZOC.437.63H� CONTRACTOR EMAIL: SIlaI1110C1.f f0 rou .net <br /> CONTRACTOR LIC.#(REQUIRED): FOYGRGC863LK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O44rj69 <br /> �.. . <br /> PRIMARY CONTACT: ❑OWNER ($I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 4,2rj.�Q.63.rj7]2 <br /> Aaron Mitchell coNr,acr ennai�: Aaron.m@foygroup.net <br /> AGREEMENT.�T hereby certify that 1 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 completed whether specified herein or not. The grenfing of a permit does nof presume to give authority fo violate or cance/the provisions of any other state or <br /> /ocal law regulafing construction or the pertormance of construction. That I am authorized by fhe 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 /> � � 02 , 5� <br /> signed by Shannon Fuller PERMIT# <br /> • US,E=Shannon.F@foygroup.net, ///��� <br /> ,F:,a Group,OU=Project Manager, I ���� � (� � <br /> F n v c rs p u €� _.�annon Fuller E U <br /> �'�y�016.02.22 08:59:11-08'00' <br /> ELECTRICAL I SOL�R � CON1AOlS �.�:.�.� <br /> Owner/Authorizetl Agent Signature Date (Revised 10/12/2015) <br />