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RE ALARM PERMIT APPLeATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> • PROJECT ITE INFORMATION; <br /> PROJECT ADDRESS:1730 Madison Street, Everett,WA 98203 BUILDING AREA: 5570 sq ft <br /> PROJECT TYPE: LI NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL <br /> P_ERIM r JNFORMATION tDESCRIPTION OF,.WORK '; " <br /> CONTRACT PRICE OF WORK: onated Labor& Matt. ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: \Sc ) <br /> Add 2 Low-Frequency Fire Alarm Notification Devices to the sleeping areas in the 2nd floor apartment. <br /> Add a smoke detector in the interior egress stairway for the 2nd floor apartment. Move Power supply for AES communicator to <br /> dedicated circuit that supplies the Fire Alarm Panel. <br /> �P�AN.REV�EW�RE4UIREMEMT: f <br /> Plan review by the Fire Department is required prior to permit issuance.Confirm the required items are included by checking the boxes: <br /> Check the boxes below to indicaticate all documents that are being submitted with this permit application: <br /> ✓❑ 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> ❑✓ 3 Sets of Plans-Must include the following: <br /> ✓❑ Location of fire alarm devices <br /> ✓❑ Battery calculations&voltage drop calculations for notification appliance circuits <br /> ❑✓ Sequence of operation in either an input/output matrix or narrative form <br /> w : r CONTACT INFORMATION <br /> OWNER NAME: Mark Matlock TENANT BUSINESS NAME(If Commercial): Kingdom Hall of JW <br /> OWNER MAILING ADDRESS: STREET PO Box 1505 kid kiA3delvt.f 1a1,t ',14,ova1ts Wif nCSSe,5 <br /> CITY Mukilteo STATE WA ZIP 98275 <br /> OWNER PHONE:425-501-9304 (OWNER EMAIL:Wevt.mmatlock@a outlook.com <br /> CONTRACTOR NAME:Owner Performed Work- "Contractor"contact Information same as Owner's above. <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: (CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED):NA CITY OF EVERETT BUSINESS UC.#(REQUIRED): NA <br /> PRIMARY CONTACT: [DOWNER ❑CONTRACTOR ❑✓OTHER(Please Specify) Project Coordinator <br /> CONTACT NAME: CONTACT PHONE:360-661-2630 <br /> Eric S I g m e n CONTACT EMAIL:eric•sigmen@gmail.com <br /> AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and <br /> 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 <br /> 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 <br /> 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 <br /> WAC. <br /> City of Everett Official Use Only <br /> PERMIT#: <br /> 2019-07-26 FA <br /> Owner/Authorized Agent Signature Date (Revised 3/6/2019) <br /> /ZL <br />