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41111� ELECTRICAL PERMIT APPLICATION <br /> .4.4► CITY OF CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 l (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> .. ........... ... . <br /> ... PROJrECT SITE INFORMA' - . ...... <br /> PROJECT ADDRESS: 4422 29th Ave SE <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX Cl MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> . .::::.:. ::.:•::.::.:.... . : .:EILECtiTRI • L_/kRPLI >t►':tt'IdN::INtilRM `T1 N.:..::. :.. ..... : : ...:.:..:,..:;;:...:... <br /> CONTRACT PRICE OF WORK:$ 250 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 100 amp temp pole Lot 208 <br /> Please call our office @ 253-872-6051 (ask for Alicia please)for payment when permit is ready Thank you <br /> �**T*:Oti1{llt4i100A}TtQ:R' 1;° :•': ._.:; : : ' :.:;: `. : g:.,;; : > :;; : <br /> OWNER NAME: Polygon Homes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 <br /> ow Bellevue STATE WA 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 <br /> cm Puyallup STATE WA zip 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele@gweusa.com <br /> CONTRACTOR LIC.#(REQUIRED}: GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 <br /> PRIMARY CONTACT: ❑OWNER VI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 258-872-6051 <br /> Paul Vantol CONTACT EMAIL: pvantol@gweusa.com <br /> AGREEMENT.I hereby certify that l 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 lam authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> / PERMIT# <br /> ' nn E \ -cc <br /> « <br /> t - 7 <br /> Owner/Authorized Agent Signature to (Revised 9/23/2016) <br />