1422 112TH ST SW SEATTLE VISION CHURCH 2019-08-20

4En- 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@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1422 112th St SW Everett, WA 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: Church ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 1600 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES ®NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: LED LIGHTING RETROFIT IN IN CHURCH BASEMENT AND CLASS ROOMS CONTACT INFORMATION OWNER NAME: Mr Kim TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1422 112th St SW un, Everett STATE WA Z,P 98204 OWNER PHONE: 425-582-1241 OWNER EMAIL: CONTRACTOR NAME: SOUND SPECIALIZED SERVICES INC CONTRACTOR ADDRESS: STREET 12433 RUGGS LAKE ROAD CITY EVERETT STATE WA ZIP 98208 CONTRACTOR PHONE; 206-427-3455 CONTRACTOR EMAIL: DAVE.W@SOUNDSSINC.COM CONTRACTOR LIC.#(REQUIRED): SOUNDSS876J9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 52341 PRIMARY CONTACT: ❑OWNER QI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-348-6714 EDWIN DOMINGEZ CONTACT EMAIL: 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 I 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 PERMIT# E\P)0(p -' 05 /47,41.-r/ Owner/Authorized Agent Signature Date (Revised 9/23/2016)