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<br /> _ECTRICAL PERMIT A- LICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 J FAX 425-257-8857 J (E) everetteps@everettwa.gov J www.everettwa.gov/permits
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<br /> PROJECT ADDRESS: 4413 30th Dr SE
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF
<br /> BUILDING TYPE: ID SFR-DETACHED ❑SFR-ATTACHED Q DUPLEX Cl MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF WORK: $ 250
<br /> NUMBER OF DEVICES (if low voltage): —
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<br /> FIRE ALARM? i YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: .. 100 amp temp River Terrace/Simpson SF lot 237
<br /> Please call our office @ 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you
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<br /> OWNER NAME; Polygon Homes �t:.�� y;� ,•,:: ..�.,�,;.. ... ;��-; �%�rr:'.. :t;rri?���`3;�:�:�i.3:�3i�3��i ��:�;�i€�e3�i-l;
<br /> yg TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTREET 11624 SE 5th StSuite 200
<br /> oiTY Bellevue �.. STATE WA
<br /> ZIP 98005
<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
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<br /> cmy Puyallup �- STATE WA
<br /> zla 9837
<br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele@gweusa,COrrl
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<br /> CON RACTOR LIC.#REQUIRED GARNEEW864K - EVERETT BUt>'=SIN.:.E..,SS L�.,IC...•# R..w UIRED..'n)•,•�X5.2.90
<br /> PRIMARY CONTACT: ❑OWNER V CONTRACTOR
<br /> 0 OTHER(Please Specify) �� LL
<br /> CONTACT NAME; CONTACT PHONE: 253-872-6051
<br /> Paul Vantol CONTACT EMAIL:
<br /> pvantol@gweusa.com
<br /> AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true end correct. All provisionsof 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 law regulating construction or the performance of'construction. That 1 em authorized by the owner of this property to perform the work for which application IS made end I
<br /> comply with the State Contractors Law 18.27 RCW and 296,200 WAC.
<br /> City of Everett Official Use Only
<br /> i1/I/,' . A .1 5/18/2017 1E \205 — \2n
<br /> PERMIT#
<br /> Owner/Authorized Agent sign tura Date (Revised 9/23/2096) `.
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