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Elm <br /> tim FIRE ALARM PERMIT APPLICATION <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 I(E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE <br /> l <br /> PROJECT ADDRESS: V l6e �/ZIC N la l 1 t/Vay BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 5.cc, ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: InS ,U I C I, � RQdi D - O Y�(1('�Yl I tDlr �K 1s1i n <br /> T 2 <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 /> I[]l 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> ❑3 Sets of Plans-Must include the following: <br /> CA 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 /> CONTACTyINFORMATION m *, `,... <br /> OWNER NAME: 1\1\1\) ?rime. �l 1�TENANT BUSINESS NAME(If Commercial): (oO `�aY ��-c�- <br /> OWNER MAILING ADDRESS: STREET to(�CI1"' h Coo5.\ �'-�k- YY./vayWA- <br /> �/�sth-e Loci <br /> CITY N z V�/ exAs l L STATE V\JI�C ZIP qCb��� <br /> OWNER PHONE: 1 2 i L-EDS- (o'bO0 OWNER EMAIL: (1IQ))C r\\N pyi WV_ co YY\ <br /> CONTRACTOR NAME: C1 J G / \4 c I m e <br /> CONTRACTOR ADDRESS: STREET 11 L1?? n I*V S \, , <br /> CITY Se tf L2- STATE A/R- ZIP gee)1✓1-4 <br /> CONTRACTOR PHONE: 2 OID'(0(2`kR� CONTRACTOR EMAIL: eLQ.i'�1SI" Cg (�Vi}"dl �(��-ty <br /> CONTRACTOR LIC.#(REQUIRED): G �`Y7'O 2-33\ -5 CITY OF EVERETT BUSINESSvLIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER NbACONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME:�� CONTACT PHONE: 4o — (02a_" (0(051-45 .e,X{• 211 <br /> wt1 <br /> 1ip"1 rl 1Ske,r CONTACT EMAIL: en5leuQ,r & qt/araf xt (, A4 -ty (DYVL <br /> 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 <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 /> ► � , Alt DA\I FA ( qo —0061 <br /> Owner G' thorized Age Signature Date (Revised 3/6/2019) <br /> (1 <br />