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FIRE ALARM PERMIT APPLILATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: I 01-l-0 A 5c I7J;_,y1c, 'BUILDING AREA: >S & sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ADDITION ❑ TENANT IMPROVMENT '-REMODEL <br /> BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX LI ADU ❑ MULTI-FAMILY-#OF UNITS: a COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ Z G�� . ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: Lkk L- (rc - �,�.� Wit' - <br /> PLAN REVIEW REQUIREMENT <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 /> ❑ Lo_. . . . - . -. AlvA <br /> "Battery calculations&voltage drop calculations for notification appliance circuits <br /> 71--Sequease-Of-Geer- - - - .u ou •. • . _ •- . •. ( A <br /> CONTACT INFORMATION <br /> OWNER NAME: r'/\tt.(-\CIA A M iLL-LTENANT BUSINESS NAME(If Commercial): FvLTcn`f 1s' 2(/ (1 <br /> OWNER MAILING ADDRESS: STREET /1 2 3 5 T• <br /> CITY � L.L tj 1JZIP c �7 <br /> �'E C; STATE L'`�;�� ! L` <br /> OWNER PHONE: Z i� _- 21-1 c;`i C't.) OWNER EMAIL: <br /> CONTRACTOR NAME: 1).A-t-( et <br /> CONTRACTOR ADDRESS: STREET �� \"0 y ( , jam- ? j • <br /> CITY /4-"TTL, STATE t..-�-vr=", ZIP ( �1`( <br /> CONTRACTOR PHONE:7 0,(c; - 7 "Q`� -32 a CONTRACTOR EMAIL: (LC,L '(' C G.t t( , (=l 5l <br /> CONTRACTOR LIC.#(REQUIRED): Pr-C, ( F(%S ?( C/ M /r CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Z <br /> PRIMARY CONTACT: DOWNER JXCONTRACTOR 70THER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: -2 v(•, - 3c) _'�• l(x <br /> i CONTACT EMAIL: 7 r���.( L �-�:;' 1~ %�--t, 7 T•v� �'R-� ^i c, � ��SC <br /> AGREEMENT: I hereby ceftify that I 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 /> FA \O Da- 001 <br /> Ownerbkuthgized Agent Signature Date (Revised 3/6/2019) <br /> �lz <br />