4315 30TH DR SE 2019-04-17 - Laserfiche WebLink

LLECTRICAL PERMIT AFJLICATION I�►� ,viti4tCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 4315 30th Dr. SE, Everett, WA 98201 /IV BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ® SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Residential use ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ has not been contracted at this time NUMBER OF DEVICES(if low voltage): FIRE ALARM? ®YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: All required electrical work for new single family residence- 3580A residence CONTACT INFORMATION OWNER NAME:Polygon WLH, LLC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 11624 SE 5th Street, Suite 100 Bellevue ciry WA STATE 98005 ZIP OWNER PHONE: 425.586.7700 OWNER EMAIL: CONTRACTOR NAME: Garner Electric Washington, LLC CONTRACTOR ADDRESS: STREET 22425-72nd Ave S carr Kent STATE WA z,P 98032 CONTRACTOR PHONE: 253.872.6051 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: (El OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425.586.7700 Alan Pani CONTACT EMAIL: alan.pani@polygonhomes.com AGREEMENT:Thereby certify that!have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE #.200°r PERMIT# 0.-e4AV h.. Panty 01/05/18 E 1(c),bI- 2972 Owner/Authorized Agent Signature Date (Revised 10/12/2015)