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TLECTRICAL PERMIT APPLICATION
<br /> own,
<br /> CITY of EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everetfwa.gov I www,everettwa.gov/permits
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<br /> PROJECT ADDRESS: 3325 31st Dr
<br /> BUILDING AREA(if residential, new construction,remodel, or addition) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED ❑ SFR-ATTACHED .D DUPLEX IZI MULTI••FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING:
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<br /> CONTRACT PRICE OF WORK;$ 250.00
<br /> NUMBER OF DEVICES (if low voltage):
<br /> FIRE ALARM? CI YES ❑NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: 200 AMP TEMP POWER POLE I /
<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 TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: srREnT 11624 SE 5th St Suite 200
<br /> cry Bellevue STATE WA
<br /> -
<br /> zip 98005
<br /> OWNER PHONE; 425-586-7700 OWNER EMAIL:
<br /> CONTRACTOR NAME; Garner Electric Washington LL,C
<br /> CONTRACTOR ADDRESS: CTREET402 Valley Ave NW Suite 106
<br /> piry Puyallup $TATE WA Zip 98371
<br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele@gweusa.com
<br /> CONTRACTOR LIC,#(R�REEQQUIR ED): GARNEEWITY EW864KB COF EVERETT BUSINESS LIC.#(REQUIRED: 052909
<br /> PRIMARY CONTACT: 0 OWNER VI CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 253-872..5051
<br /> Paul Vantol CONTACT EMAIL;pvantol@gweusa.corp
<br /> AGREEMENT:I hereby certify that!have read and examined this application and know the same to be true and correct All provisions of 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 gNs authority to violate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property to perform the work for which application Is made and I
<br /> comply with the State Contractors Law 18.27 RCWand 288.200 WAC.
<br /> CitY of Everett Official Use Only
<br /> PERMIT#
<br /> 4 2 E 1� -2A (4
<br /> Owner/Authorized Agent Sig ature Date (Revised 9/23/2016)
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