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ELECTRICAL PERMIT ARLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 1 FAX 425257-8857 1 (E) everettepsgaverettwa,gov 1 www.everethva.gov/pemiits <br /> , I <br /> >FO�N1.MYtiOK1 , <br /> PROJECT ADDRESS: 4316 30th br SE <br /> BUILDING AREA(If residential,new Construction, remodel,or addition)__ _ SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: <br /> 1N1=0F�11)I"T <br /> CONTRACT PRICI; OF WORK: $ 750 <br /> NUMBER OF DEVICES If low voltage): <br /> FIRE ALARM? ❑YES ® NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION O WORK: Moving two dining room cans and adding two dining room cans. <br /> Simpson of 147 <br /> ! dui ems, o. <br /> � 12 � <br /> CONVICT IM>`ORMATION <br /> OWNER NAME:Polygon HorreS TENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS: STILeT 11624 SE 5th St Suite 200 <br /> oma Bellevue STATE WA "'. 98005 <br /> OWNER PHONE: 425586-7700 7 OWNER EMAIL: <br /> CONTRACTOR NAME: Garner Electric Washington LLC <br /> CONTRACTOR ADDRESS: sT1EET402 Valley Ave NW Suite 106 q [�O <br /> OITY Puyallup STATE WA ZIP 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: droberts@gweusa.COm <br /> CONTRACTOR LIC.#(REQUIRED): GARNEEW864KBCITY OF EVERETT BUSINESS LIC. <br /> #(REQUIRED)-2n09 <br /> PRIMARY CONTACT; ❑OWNER Q CONTRACTOR ❑ <br /> OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253_872-6051 <br /> Dale Roberts CONTACT EMAIL: agentelep gweusa.com <br /> AGREEMENT:1 hereby certify that 1 have read and examined this application and know the seme to be true and corraot. All provisions of laws and ordinancesgoverning this type <br /> of work will be completed whether specified herein or not. 'The granting cf a permit does not presume to give authority to violate or CAhce!the provisions of any other State or <br /> local law regulating constructfon or the performance of construction, That 1 am authorl,ed by the owner of this properly to perform the work for which applicatlon!S made and 1 <br /> Comply with the State Contractors Lew 18,27 RCW end 296.200 WAC, <br /> Clty of Everett Official Use Only <br /> PERMIT# <br /> 2/28/17 E Q - 002 <br /> Owner/Author¢ed Agee Signature Date (Revised 9/23/2016) <br />