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t�ECTRICAL PERMIT API��ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov � www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 3002 HO t Ave <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: R@tall <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 3,500 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install four LED lights over store entrance. Install track lighting over retail display inside of store. <br /> CONTACT INFORMATION <br /> OWNER NAME:GOOdWIII ICICIUStC'I@S TENANT NAME(If Commercial): GOOCIWIII IC1dUSt1"I@S <br /> OWNER MAILING ADDRESS: sTREEr 3002 Hoyt Ave <br /> �,n Everett STATE WA Z,P 98201 <br /> owNeR PHONE: 425-252-6163 OWNER EMAIL: <br /> CONTRACTOR NAME: ZOC'k0 EI@Ctl'IC, Inc. <br /> CONTRACTOR ADDRESS: sTReeT PO BOX �OO <br /> cin. �UVall STATE WA ziP 98019 <br /> CONTRACTOR PHONE: 4ZrJ-78H-77�O CONTRACTOR EMAIL: kentV p�ZOC'I(O@I@CtI'IC.COCYI <br /> coNTRncroR�ic.#�REQu�RE��: ZORKOE1121 OK CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O4H52O <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2�6-'j3�-�542 <br /> Jim Gordon coNTACT EMai�:jimg@zorkoelectric.com <br /> AGREEMENT:I hereby certify that I have iead and examined this application and know the same to be true and conect. A/l provisrons 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 violate or cancel the provisions of any other state or <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> � PERMIT# <br /> 2 �c 1'� E 2—� 6�� <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />