|
RE ALARM PERMIT APPLIITION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 1(E)
<br /> everettepsaevereettttwa.gov I www.everettwa.gov/permits
<br /> sl "kYE Y " Vrf i 4AEP IXIIyFO VI V wr
<br /> 2g: -1r ;,:2E: .e+a�,44 :
<br /> PROJECT ADDRESS: 3 M e- D0 u.i aJ_ . GtArttrum_ BUILDING AREA: 0IT'n' e- 01 sq ft
<br /> PROJECT TYPE: El NEW CONSTRUCTION El ADDITION 2 TENANT IMPROVMENT ❑REMODEL
<br /> BUILDING USE: El SFR El TOWNHOUSE ❑DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: R'COMMERCIAL
<br /> �.,�5 E:MOE *Rt4ITINFO MAT N Rl IN f R , � V ri
<br /> .�.�,.. c.....a.;...�.�.r .,r.: ...__k�...��_��>_�.x ..� r .�,_. �.._�l,_ _.� � .,... �s.��_`.v_ i ,�. �,,,.� "� SII.. r�..,x R"V
<br /> CONTRACT PRICE OF WORK:$ do-al . OD ASSOCIATED ELECTRICAL PERMIT#(REQUIRED):
<br /> DESCRIBE SCOPE OF WORK: F►rt AL. 'v". 'f-•Z• 1J 1'4 c.o CA' a v..L r-e-vvi. vC. Olt.t u c t
<br /> s,,h.c4 t d et ec tvr From R r U . 3-v►.stu-1 l Y\.e4.0 d u. t 5✓nok_c, 4 eFec tuY.
<br /> Pry I LyE.- 00 same_ •{tiMv.o. _
<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 /> ec
<br /> L_7,/3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets)
<br /> LJ 3 Sets of Plans-Must include the following:
<br /> Er Location of fire alarm devices
<br /> ❑ Battery calculations&voltage drop calculations for notification appliance circuits
<br /> Er Sequence of operation in either an input/output matrix or narrative form
<br /> CONT/ CTtINFORMA1 O
<br /> OWNER NAME: Sy1 O 1QO-tl2 A,wvA J TENANT BUSINESS NAME(If Commercial): M 0 DO 1. U -t-t S kup
<br /> OWNER MAILING ADDRESS: STREET (TDD R 0 c -e
<br /> CRY `'y`4-eAvi STATE vu/ • ZIP q P)3
<br /> OWNER PHONE: 4f-c X54 • 444B 'OWNER EMAIL: c hu.d •SFarkerk.lo S✓t0l'to144.:511. Loci. .u5
<br /> CONTRACTOR NAME: It0►r lnw/e-&r Pi(6 SVJb('e-vv c �-I--C
<br /> CONTRACTOR ADDRESS: STREET a -5 8
<br /> `43rd AV'2.- 5 3t I) n
<br /> CRY K�y�, STATE wk ZIP_`/�
<br /> 8O 3
<br /> CONTRACTOR PHONE:ZOlo4'41 _CONTRACTOR EMAIL: tt c,-
<br /> orrte n w Fi✓f 5 51- 5.Cory-.
<br /> CONTRACTOR LIC.#(REQUIRED):1J0QrN F 81E 1-13- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0 4 8114
<br /> PRIMARY CONTACT: DOWNER
<br /> LvJ,,�..,// ,. `^ 2 .,,.:!. .,..., ..: ., ,r,-., z,, ..,,< as a�• ,�.",,. ,.y .. ",rs,.c r#� „'s*.., r.. c .> .
<br /> CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: a O to D.• 7" Spa.
<br /> { Reatr CONTACT EMAIL: &Or2G.1rc.7SL f-e.✓"i5 ,L-0
<br /> AGREEMENT:/hereby certify that/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 /> 44k; 1•1 wi-Otureat- r,t FA VcM — CO c
<br /> Owner/Authorized Agent Signatere Date 0 3°a 6• a01 (Revised 3/6/2019)
<br />
|