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RECTRICAL PERMIT APPICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: A 306 O t BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: E N INFORMATION CONTRACT PRICE OF WORK: NUMBER OF DEVICES (if low volta e : -- --------- FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: landscape U II htin 4 fixtures for permanent entry monument see CONTACT INFORMATION OWNER NAME: Polygon WLH, LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100 CITY Bellevue STATE WA ZIP 98005 OWNER PHONE: 425.586.7700 OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET 2� r CITY �V \ STATE �7 dZIP �8 _0 1 CONTRACTOR PHONE: '-AVS 25 rT CONTR0ACCTOR EMAIL: _( �� CS ` CONTRACTOR LIC,#(REQUIRED): ko 1c) CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ®OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425.586.7700 Jamie Aubrey CONTACT EMAIL: jamie.aubrey@polygonhomes.com AGREEMENT.T 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 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 local law regulating construction or the performance of construction. That/am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# 10/12/2016 E —o-I Owner/Authorized Agent Signature Date (Revised 10/12/2015)