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

ELECTRICAL PERMIT APPLICATION 2ErrCITY 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.everettwagov/perrnits PROJECT SITE INFORMATION PROJECT ADDRESS: 4315 30th Dr SE BUILDING AREA(if residential,new construction. remodel, or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS. 0 COMMERCIAL USE OF BUILDING: TRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 250 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 100 amp temp pole Simpson lot 156 Please call our office © 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you CONTACT INFORMATION OWNER NAME: Polygon Homes TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREE- 11624 SE 5th St Suite 200 cm, Bellevue STATE WA ip 98005 OWNER PHONE: 425-586-7700 OWNER EMAIL: CONTRACTOR NAME: Garner Electric Washington LLC CONTRACTOR ADDRESS: STRUT 402 Valley Ave NW Suite 106 cm: Puyallup SE WA .-qp 98371 CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele©gweusa,corn CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#IREQUIRED): 052909 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-872-6051 Paul Vantol CONTACT EMAIL: pvantol@gweusacorn AGREEMENT'llie,eby certify that I have read and examined this application and know the same to be true and correct Alf 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 a 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 1027 RCW and 296 200 WAG. City of Everett Official Use Only PERMIT# /1/1 1 1 4 oka tti 3/22/18 . Owner/Authorized Agent Sig ature Date (Revised 123/2016)