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08/21/2006 07: 03 25328821 GARNER ELECTRIC0 PAGE 02/03 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 4.25-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/perm its q '6� 6 Aft"t Ob J PROJECT ADDRESS: 4 4 0 3-2-9tb-A`ve-&E OY. S62 AV BUILDING AREA(if residential, new construction, remodel, or addiflori)-- SF ,BUILDING TYPE: 0 SrR,DP-TACHErj MSFR-ATTACF1E-D CIDUPLEX 0 MULTI-FAMILY-0-OF UNITS: EJ COMMERCIAL IUSE OF BUILDING: CONTRACT PRICE OF WORK: $ 250 NUMBER OF DEVICES If low voltage): FIRE ALARM 7 El YES El NO ASSOCIATED BUILDING PERMIT# if appliceIble): DESCRIPTION OF WORK: 100amp temp pole ,Lot 13O- R219 OWNER NAME:Polygon Homes TENANT NAME if Comi-nercial).. OWNER MAILING ADDRESS: STRFr'l' 11624 SE 5th St Suite 200 CITY Bellevue STATF WA ... 98005 OWNER PHONE. 425-586-7700 1OWNER EMAIL: CONTRACTOR NAME: Garner Electric Washington LLC CONTRACTOR ADDRESS: IT11SIT402 Valley Ave NW Suite 106 ciTv Puyallup 6TATr WA zip 98371 CONTRACTOR EMAIL- pvan-tolQgWeuSa.corn CONTRACTOR PHONE: 253-872-6051 CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB 1C1TY OF EVERETT BUSINESS LIC.#(REEQUIRED):052909 PRIMARY CONTACT: 0 OWNER 2 CONTRACTOR 11 OTHER(P]Gaso Specify) CONTACT NAME: CONTACT PHONE: 253-278-7064 Paul Vantol CONTACT EMAIL'pvantol@qweusa.com AGREEMENT,I 11crc?)y collIfy that I havo read and oxaMined th],,z applIcallon and know the same to be thfo Lind Correrl, All provisions of laws and ordinances gwvomlnq this type of wont will bo romplrred whether specf(iod herein or not. The gamtlng of permit does not presume to.<;fw,owhority to violate or cancel the provislons ofeny other wore or That I arn sutliorl7ed by the owner ofthis property foperform the m.rk for which applicellon Is made and I comply with the State Conti-ectont L,aw 18.27 RCWgnd 296.200 WAC, Clty of Everett OtPclal Wr,Only PERWTO A6 a// IE � - \R9 L W2- ownerlAUthorized Agent Sl. ature b o (Rev/sod 9/23/2016)