4419 30TH DR SE 2021-12-15 - Laserfiche WebLink

�CTRICAL PERMIT AP ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX: 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: 4415 30th Dr. SE, Everett, WA BUILDING AREA (if residential, new construction, remodel, or addition) ' SF BUILDING TYPE: M SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI -FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: Residential use CONTRACT PRICE OF WORK: $ has not been contracted at this time NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES ❑ NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: All required electrical work for new Sinqle Family - 2640A residence OWNER NAME: Polygon WLH, LLC TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100 Bellevue CITY WA STATE 98005 ZIP OWNER PHONE: 425.586.7700 OWNER EMAIL: CONTRACTOR NAME: Garner Electric Washington, LLC CONTRACTOR ADDRESS: STREET 22425 - 72nd Ave S CITY Kent STATE WA zip 98032 CONTRACTOR PHONE: 253.872.6051 CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): GARNEEW864KB ICITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ® OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Alan Pani ONTACT PHONE: 425.586.7700 ONTACT EMAIL: alan.pani@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 I 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. 01n,►ti L PA n4, 02/09/2017 Owner/Authorized Agent Signature Date City of Everett Official Use Only FEE — 4 1%( p(??, PERMIT # (Revised 10/12/2015)