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0110111P- <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT'PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 l FAX 425-257-8857 l (E)everetteps@everettwagov I www,everettwei.goviperinits. <br /> PROJECT ADDRESS: 451.7.31st Ave SE <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ,fitiif ;a s.. .. :,_.. 1.*..., .e..< .. w , <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: 200 amp temp service for Job Shack <br /> Please call our office(258-872-6051 (ask for Alicia please)for payment when permit is ready Thank you <br /> OWNER NAME:Polygon Homes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: smEET 11624 SE 5th St Suite 200 <br /> crew 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 10 <br /> errv;Puyailup swArE WA ZIP 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL bge !tele 4©gweusa.coI7t <br /> CONTRACTOR LIC REQUIRED). OARNEEVV864KB CITY OF EVERETT BUSINESS LIG.#(REQUIRED): 052909 <br /> PRIMARY CONTACT: Cl OWNER G:1 CONTRACTOR ©OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: '253-872-6051 <br /> Paul Vantol CONTACT EMAIL: Yatntol tgweusa.cott1 <br /> AGREEMENT:i hereby certify that I have read and.examined this application and know the same to be true and Coned Alt 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 pies/mato give authority to violate or cancel the provisions of any other state or <br /> local lawregutat€ng construction or the performance of construction. That tam autimrired by the owner of this property ai perform the work for which application is matte and] <br /> comply with the State Contractors Law 18.27 RCW and 28&200 WAC, <br /> Citgo€Everett Official Use Only <br /> PERMIT# <br /> 1123/18 E \�O - 1� 3 <br /> • <br /> Darner/Authorized Agent ignature Date (Revised 9/23/2016) <br />