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e_LECTRICAL PERMIT APPLICATION <br /> agilliP CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov1 www.everettwa.govipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 4424 31st Ave SE <br /> BUILDING AREA of residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: Vl SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-11 OF UNITS0 COMMERCIAL <br /> USE OF BUILDING: <br /> 'ELECTRICAL APPLICATION INFORMATION <br /> ,...k ..., . <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 254 <br /> Please call our office © 253-872-6051 (ask for Alicia please) for payment when permit is ready Thank you <br /> . <br /> CONTACT INFORMATION <br /> OWNER NAME: Polygon Homes TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 <br /> .,., Bellevue TATE WA zi,, 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 /> cir, Puyallup sr,,,,i_ WA 7,p 98371 <br /> CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: hgentele@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@gweusacorn <br /> AGREEMENT I 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 type <br /> of work will be completed whether specified herein or not The granting of a permit does not presume to give authority to ago/ate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction That I em 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 RCW and 296.200 WAC <br /> City of Everett Official Use Only <br /> , <br /> , 7—' f 4 <br /> I <br /> 1 PERMIT# <br /> / i <br /> 915/17 E r-4eq - 03c;t <br /> , <br /> ,,/ i., <br /> s <br /> Owner/Authorlzed Agent ‘ nature' '' Date (Revised 9/23/2016) <br />