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•ECTRICAL RI
<br /> CITY OF EVERETTPEPERMITMITASERVICESLICATION
<br /> /11 ---A.
<br /> v�� 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 /> =" s' Z . V w,:,', PR'OJEC7 SITE x FORMATION i
<br /> PROJECT ADDRESS: 4425 30th Dr. SE, Everett, WA
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) 1,684 SF
<br /> BUILDING TYPE: ill SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING: Residential use
<br /> "„°5,+ "v't' Y d s-, Sl'. 4"'"kd P ",^,-y ar +aY' 3YA. 't ",. tl 4,,,`;A;?
<br /> -t ,fir{ak7 2 S :. y,^^ � ,��,r, apry `y t *,
<br /> a _ ELECTRIC L ` PLIICAT ONS Afi OI�M ;
<br /> ..m_. a .: ,...,»,y�;?,»�i?� ,mi<- Yui+. - ¢...:.s... � Asx rAAa, 1 + ,c-. .. . ..,., 'r�awaxk.<,,3�.., .� �.ri p .,.. w=Cesss.±�....,fir�.�,.#C.=TM`4,";. .' . .**,r,° i VV *::af
<br /> CONTRACT PRICE OF WORK: $ has not been contracted at this time
<br /> NUMBER OF DEVICES(if low voltage):
<br /> FIRE ALARM? 0 YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: All required electrical work for new Single Family- 2640A residence
<br /> "CONTACT INFORMATION
<br /> OWNER NAME:Polygon WLH, LLC TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100
<br /> Bellevue crry WA STATE 98005 ZIP
<br /> OWNER PHONE: 425.586.7700 OWNER EMAIL:
<br /> CONTRACTOR NAME: Garner Electric Washington, LLC
<br /> CONTRACTOR ADDRESS: STREET 22425 - 72nd Ave S
<br /> CITY Kent STATE WA ZIP 98032
<br /> CONTRACTOR PHONE: 253.872.6051 CONTRACTOR EMAIL:
<br /> CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED):
<br /> PRIMARY CONTACT: ®OWNER 0 CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 425.586.7700
<br /> Alan Pani
<br /> CONTACT EMAIL: alan.pani@polygonhomes.com
<br /> AGREEMENT:T 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
<br /> 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
<br /> local law regulating construction 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 I
<br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> FEE C�
<br /> `tel
<br /> PERMIT#
<br /> a tan. b_ Patti, 02/09/2017 E f o C.Q' hl
<br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015)
<br />
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