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ELECTRICAL PERMIT APPLICATION <br /> 'II,JA- CITY OF EVERETT PERMIT SERVICES <br /> `� 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> ......_............ffg.......................................................... .....:.. ° i :s.:.°: PROD <br /> .:�... . ECT.:: TE.:<INF.ORMATI: . . ;:•;::::.:;:.: :° ' :;`:'' �<` . �' � ;<..::::: <br /> ........:.................................................................................... <br /> PROJECT ADDRESS: 4501 31st Ave SE <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> :;:: E:;.:.w::;o::::::::::::::<:::z:<:: :::: ::>. ,-. .:.•..:- ELECTRICAL APP:LICATION..INFQRM/1TIION .. .. .... ...... . .... , ....:,: .,.. <br /> CONTRACT PRICE OF WORK:$ 250 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES ❑NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 100 amp temp pole Lot 274 <br /> Please call our office @ 253-872-6051 (ask for Alicia please)for payment when permit is ready Thank you <br /> : .'.... ......:. . .. .::. ::: :i: '...GONTACT;1lN.10RMpT'10N: ";:'::: .:': ..: ' : ., .: ' :: :` ;-. ;; :;i.t'`':'• <br /> OWNER NAME: Polygon Homes 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 /> CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106 <br /> CITY 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 UC.#(REQUIRED): 052909 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 253-872-6051 <br /> Paul Vantol CONTACT EMAIL: pvantol@gweusa.com <br /> AGREEMENT,I hereby certify that I have mad 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 I <br /> comply With the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> "....A-C . li.,-, 1 11, /O7-/7 PERMIT# <br /> '1; ii ia/ *.) ii • :.,-, ,el"' <br /> Owner/Authorized Agent Signa ure ate (Revised 9/232016) <br />