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CLECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />00�= 3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: 9509 19TH AVE SE, EVERETT, WA 98208 <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: CHURCH <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ 21,665.00 <br />NUMBER OF DEVICES (if low voltage): 134 <br />FIRE ALARM? 121 YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: INSTALLING Addressable Silent Knight Fire Alarm System <br />CONTACT INFORMATION <br />OWNER NAME: Church Of Latter Day Saints TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: STREET 9509 19TH AVE SE <br />c,T., EVERETT STATE WA Z,, 98208 <br />OWNER PHONE: 360-671-0166 <br />OWNER EMAIL: <br />CONTRACTOR NAME: SECURITY SOLUTIONS NW <br />CONTRACTOR ADDRESS: STREET 1619 N STATE ST <br />,,,r, BELLINGHAM STATE WA Z,p 98225 <br />CONTRACTOR PHONE: 360-734-4940 <br />1CONTRACTOR EMAIL: DUSTINK@SSNW.CO <br />CONTRACTOR LIC. #(REQUIRED): SECURSN954JG <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 045070 <br />PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />DUSTIN KOENIG <br />CONTACT PHONE: 360-81 5-0160 <br />CONTACT EMAIL: DUSTINK@SSNW.CO <br />AGREEMENT: I hereby certify that/ 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 violate or cancel the provisions of any other state or <br />local law regulating construction or the performance of construction. That l 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 />AE I - 2 <br />Agent Signature Date (Revised 912312016) <br />7 <br />'Z <br />