4502 RIVERFRONT BLVD 2018-07-25 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION �011W41CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps a©everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4502 Riverfront Blvd BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: f, , CTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 250 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 100AMP Temp Lot 219 Please call our office @ 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you CONTACT INFORMATION OWNER NAME: Polygon Homes TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 ciry Bellevue STATE WA z,p 98005 . OWNER PHONE: 425-586-7700 OWNER EMAIL: CONTRACTOR NAME: Garner Electric Washington LLC CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106 c,,, Puyallup STATE WA zip 98371 CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele@gweusa.com CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: 0 OWNER [1 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-872_6051 Paul Vantol CONTACT EMAIL: pvantol@gweusa.com AGREEMENT I 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 construct on 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 l comply with the State Contractors Law 1827 RCW and 296.200 WAC. City of Everett Official Use Only t ''1 1 - PERMIT# L" ` ,fir . 1X151 E \,q-(2 - 030 r" Owner/Authorized Agent Signare Date (Revised 9/23/2016)