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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 ( FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />PROJECT ADDRESS: 3401 31 st Dr, Everett, WA <br />BUILDING AREA (if residential, new construction, remodel, or addition) 1,960 SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ® MULTI -FAMILY - # OF UNITS: 5 ❑ COMMERCIAL <br />USE OF BUILDING: Residential use <br />CONTRACT PRICE OF WORK: $ has not been contracted at this time <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ® YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: All required electrical work for new Unit G of Bldq 9, a residential 5-Dlex townhome <br />OWNER NAME: Polygon WLH, LLC TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100 <br />Bellevue CITY WA STATE 98005 ZIP <br />OWNER PHONE: 425.586.7700 1OWNER 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: M OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: 425.586.7700 <br />Alan Pani 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/ 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 />3/ LOAl , <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />FEE <br />5� <br />PERMIT # <br />E (104- <br />(Revised 1011212015) <br />