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oreryELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 1 (P) 425-257-8810 I FAX 425-257-8857 l (E) everetteps@everettwa.gov j www.everettwa.gov(permits <br /> ^ 4K .' r ,b aw -e,...ys,?,N, ,s7�400. .g. ." .+;� e mi �' <br /> PROJECT ADDRESS: 3411 3 1st Dr <br /> BUILDING AREA(11 residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX la MULTI-FAMILY-#OF UNITS: <br /> ❑ COMMERCIAL <br /> USE OF BUILDIN3G; <br /> CONTRACT PRICE OF WORK: $ 250.00 a.b:� 4$.. -....4,,M� • ''.. " ~• ` <s <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? O YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 200 AMP TEMP POWER POLE <br /> a \ (ooq _ Lg - <br /> Please call our office © 253-872-6051 ask for Alicia please) for payment when <br /> dpi <br /> F ° permit <br /> ellready <br /> is rea R.i.,yank you u <br /> b. . y v . la ��+si ,j + m <br /> 1. , .„ ., ,f ,� r.. , �, , s ,:,.. . . . . i�k ,On. a,M ,:., ; . <br /> , §OWNER NAME: Polygon HomesTENANT NAMME(fmec ) <br /> OWNER MAILING ADDRESS: STREET 11624 SE 5th St Suite 200 <br /> C,n Bellevue STATE WA <br /> OWNER PHONE: 425-586-7700 zea 98005 <br /> ,. .... ., ,. ... OWNER EMAIL: <br /> CONTRACTOR NAME: Garner Electric Washington LLC <br /> CONTRACTOR ADDRESS: STREET 402 Valley Ave NW Suite 106 <br /> aTv Puyallup STATS WA z,P 98371 <br /> CONTRACTOR PHONE: 253-872-5051 CONTRACTOR EMAIL: bgentele@gweu5a.COm <br /> CONTRACTOR LIC.#REQUIRED): GARNEEW864K13 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052909 <br /> • <br /> PRIMARY CONTACT: 0 OWNER 10 CONTRACTOR El OTHER(Please Specify) <br /> CONT ACT NAME: x,... ,..,..,:;�..._ <br /> CONTACT PHONE: 253.872-6051 <br /> Paul Vantol CONTACT EMAIL: <br /> AGREEMENT-i herebyCern' that Ihave �� Avant°I a gweusa.com <br /> 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 peen/t 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 I am authorized by the owner of this <br /> comply with the State Contractors Lew 18.27 RCW and 298.200 WAG. property to perform the work f(7r which application is made and 1 <br /> City of Everett Official Use Only <br /> 4 r PERMIT# <br /> 1ii . 1 /11,?-05 - 0� <br /> Owner/Authorized Agent Slgnatu O <br /> Date �- <br /> (Revised 9/23/2096) <br />