|
ILECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P) 425-257-8810 ( FAX 425-257-8857 J (E) everetteps@everettwa.gov www.everettwa.gov/permits
<br /> �" �tk�'. 1 Ik yea •��JtJ"1rTM]� � ; e r� a 1'�i � , �,1 '�.. ':(,: v •�`• � t: p
<br /> ,p',1),%0,. ``. ., ' "`z.. •+r t 4 ` r� � t � � R ;.' ,f Y >'_� yi 7C v . :Ssek
<br /> ` V, S�.x r �i�'' �r .Jsr�t'�.-.,
<br /> PROJECT ADDRESS: 3347 31st Dr
<br /> BUILDING AREA(if residential,new construction, remodel,or addition) Sr
<br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ®MULTI-FAMILY-#OF UNITS: I] COMMERCIAL
<br /> USE Or BUILDING;
<br /> •
<br /> 4111
<br /> Z��q�t15�a+•o
<br /> y11H11W5J5' 4ti *i AL"'
<br /> '�S �p1�
<br /> �•yV r•!, Tr.
<br /> 11y 's1i 2f,r,;. 4e la m .���;:.r. _ =Vin_ � .ur., —
<br /> CONTRACT PRICE OF WORK: $ 250.00
<br /> NUMBEROF DEVICES if low voltage):
<br /> FIRE ALARM? ❑YES 0 NO '
<br /> ASSOCIATED BUILDING PERMIT# if applicable ; •
<br /> DESCRIPTION OF WORK: 200 AMP TEMP POWER POLE
<br /> Please call our office @ 253-872-6051 (ask for Alicia please)for payment when permit is ready Thank you
<br /> •,.:::.:•.:1,�vn'af..e;/. k;.�.0. •,y'�4..>�;,,,.,.{.....':si'_:.::•,,:::rr'.' "'"ri4`e .,r}:�"::hi:°,;"•'.»:.•"
<br /> ,
<br /> ... :.t..e3,....`Sw..�-. :aki. '„,i ao �.� • L ,''•:54hr'
<br /> �I..� t,...r.�r._,:s•h-•�i>t�6<:�^a.,.''•'i„s:Etc:•.�:::w;:;.��e;Y,3x`4e>:'•.;;ii„:�-'
<br /> OWNER NAME: Polygon Homes
<br /> ------w f TENANT NAME(If Commercial :
<br /> OWNER MAILING ADDRESS; STREET 11624 SE 5th St Suite 200
<br /> CITY Bellevue STATE WA ZIP 98005
<br /> OWNER PHONE: 425-586-7700 OWNER EMAIL:
<br /> CONTRACTOR NAME: Garner Electric Washington LLC
<br /> �r .......,.�•,... ,. .�..... .....� . ,,.... .......... ... ... ......... . „.._.:. ,,.�. .......,,�d
<br /> CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106
<br /> circ Puyallup STATE WA ZIP 98371
<br /> CONTRACTOR PHONE: 253-872-6051 'CONTRACTOR EMAIL: bgentele@gweusa.com
<br /> cONTRAC 'OP LIC.#REQUIRED): GARNEEW864KB
<br /> CITY OF EVERETT BUSINESS LIQ#jR�QUIRED): aJ�29Og
<br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR , 0 OTHER(Please
<br /> . Specify) w-..._....„
<br /> ( Spe
<br /> CONTACT NAME: CONTACT PHONE: 253-872„6051
<br /> Paul Vantol CONTACT EMAIL: pvantol@gweusa.com
<br /> AGREEMENT.:f 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 give authority to violate or cancel the provisions of any other state or
<br /> local law regulating construction or the performance of construction. That l ern authorized by the Owner of this property to perform the work for which application is made and I
<br /> comply with the Stale Contractors Law 18.27 RCW and 296.200 WAC
<br /> City of everett Oficial Use Only
<br /> / PERMIT#
<br /> • �` 4� 4/ —4er 11 E net
<br /> Owner Authorized Agent Signature Date
<br /> (Revised 8/23/2096)
<br />
|