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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> . ................ .... <br /> . ,. . ... .._ . . . . . .. .. WJE S FQ N:::::.:::.~..:.:.: <br /> PROJECT ADDRESS: 4508 31st Ave SE <br /> BUILDING AREA(If residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: <br /> ::;:.:::.:,.;:: <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 250 <br /> Please call our office @ 253-872-6051 (ask for Alicia please)for payment when permit is ready Thank you <br /> .... ...:: . <br /> ..: :.:...: .;:.:.:.:::.,.:.,,:.::.::-.�,.... .;.:: .. ......:..::::...:.:.. :.,,..:::. :.: ..:0 : TACT;<L..FCRMATIQ:N.:`:; �>>�.�.�.; :`°: ': '° ::::.:�:: :�`: �'� �':' ;;':i:;:':"i •`! �:: : <br /> OWNER NAME: Polygon Homes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 <br /> cm, Bellevue STATE WA ZIP 98005 <br /> OWNER PHONE: 425-586-7700 OWNER EMAIL: <br /> CONTRACTOR NAME: Gamer Electric Washington LLC <br /> CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106 <br /> CTT., Puyallup STATE WA ZIP 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele@gweusa.com <br /> CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 <br /> PRIMARY CONTACT: 0 OWNER lZ CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-872-6051 <br /> Paul Vantol CONTACT EMAIL pvantol@gweusa.com <br /> AGREEMENT::!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!am 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 /> , � f; .L l E -- LOG( <br /> owner/Authorized Agent Signature •ate (Revised 9/23/2016) <br />