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LECTRICAL PERmg APPLiCATION <br /> E <br /> /4011414°P7/ T WA 8201 <br /> 3200 CEDAR STREET. <br /> UPI' OF E\IERETT PEEvREMRITETSE.RVICES <br /> verettiva.goviclermits <br /> P)425-257-B80 \ FX 425-257-8857 \ (E.) everetteps©everettwa.gov\ www,e <br /> PRO3'ECT SINE MORIMMOIsi ,, <br /> 1 <br /> PROJECT ADDRE.SS: 4617 31st Ave SE <br /> BUILDING AREA(if residential,new construction, remodel, or addition) SF <br /> - . 0 COMMERCIAL <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI FAMILY #OF UNITS <br /> USE OF BUILDING: . <br /> . - <br /> E ;;1767AL APPLICATION INFOOMATION <br /> CONTRACT PRICE OF WORK: $ 200 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? DYES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): . <br /> DESCRIPTION OF WORK: 100 amp temp <br /> lot 346 <br /> Please call our office @ 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you <br /> CONTACT INFORMATION <br /> OWNER NAME: Polygon Homes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 <br /> cn, Bellevue STATE WA zr 98005 : <br /> t , i- <br /> , <br /> OWNER PHONE: 425-586-7700 OWNER EMAIL; <br /> CONTRACTOR NAME: Garner Electric Washington LLC , <br /> CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106 <br /> CITY Puyallup STATE WA ,,,,,,, 98371 : <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: dgentele©gweusa.com <br /> CONTRACTOR LIC.It(REOUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR D OTHER(Please Specify)- <br /> CONTACT NAME: CONTACT PHONE: 253-872-6051 <br /> Paul Vantol CONTACT EMAIL: pvantoi@gweusa.com <br /> AGREEMENT I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> 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 raw reoulahno construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAG <br /> / . City of Everett Official Use Only . . <br /> /Si/ / / <br /> ( ---1 :-`t 47/li lite ;;.. ,,„q/, 7/1 6/1 9 PERMIT AOwner/A uth6rizeir Agent Signature E <br /> Date <br /> (Revised 9/23/2016) . <br /> ...,.....__ _____ <br />