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ELECTRICAL PERMIT APPLHATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov I vwvw.everettwa.govipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 4510 29th Ave SE <br /> BUILDING AREA(if residential,new construction. remodel, or addition) SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLIWION INFORMATION <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 <br /> lot 202 <br /> Please call our office © 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you <br /> CONTACT INFORMATION <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: Garner Electric Washington LLC <br /> CONTRACTOR ADDRESS: sTREEt 402 Valley Ave NW Suite 106 <br /> cr, Puyallup STATE WA zip 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: dgentele@gweusa.com <br /> CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 <br /> PRIMARY CONTACT: 0 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 read and examined this application and know the same to be true and correct. At/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)ant 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 ROW and 296.200 WAC <br /> City of Everett Official Use Only <br /> 171) PERMIT# <br /> / 7(77 (511 2/14/18 E <br /> Owner/Authorized Agent .ignature Date (Revised 9/23/2016) <br />