4509 31ST AVE SE 2019-04-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION •, CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwagov I www.everettwa.govfpermits PROJECT SITE INFORMATION PROJECT ADDRESS: 4509 31st Ave 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: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 250 NUMBER OF DEVICES (if low voltage): FIRE ALARM? CI YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 100 amp temp lot 278 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: STREET 11624 SE 5th St Suite 200 G,,, Bellevue STATE WA z,,: 98005 OWNER PHONE: 425-586-7700 OWNER EMAIL: CONTRACTOR NAME: Garner Electric Washington LLC CONTRACTOR ADDRESS: srREET 402 Valley Ave NW Suite 106 ciT,. Puyallup STATE WA 7,, 98371 CONTRACTOR PHONE: 253-872-6051 CONTRACTOR EMAIL: bgentele@gweusa.com CONTRACTOR LIC.#(REQUIRED): GARNEEW864KB CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 253-872-6051 Paul Vantol CONTACT EMAIL: pvantoli@gweusa.com 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 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 1 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 ' ?_ , :' (T a 1 L Li/ 2/14/18 PERMIT 1 6 2CP1 Owner/Authorized Agent Signature Date (Revised 923/2016)