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Nim <br /> RE ALARM PERMIT APPLIaTION <br /> E V E R E T TCITY 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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: (3Z/ CO 1 lot/ BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑NEW CONSTRUCTION ❑ADDITION 0 1LENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ❑SFR El TOWNHOUSE El DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$18465 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED):El 905-094 <br /> DESCRIBE SCOPE OF WORK: <br /> Modify existing fire alarm system Colby Campus D Wing Level 2 Pharmacy. <br /> Joint venture between Johnson Controls Fire Protection and Veca Electric. <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 /> 0 Location of fire alarm devices <br /> 0 Battery calculations&voltage drop calculations for notification appliance circuits <br /> ❑✓ Sequence of operation in either an input/output matrix or narrative form <br /> CONTACT INFORMATION <br /> OWNER NAME: Providence General Medical TENANT BUSINESS NAME(If Commercial): Providence Regional MC <br /> OWNER MAILING ADDRESS: STREET PO Box 1067 <br /> C1TY Everett STATE WA zip 98206 <br /> OWNER PHONE:425-261-2000 OWNER EMAIL: <br /> CONTRACTOR NAME:Johnson Controls Fire Protection <br /> CONTRACTOR ADDRESS: STREET 9520 10th Ave S. Suite 100 <br /> cm( Seattle STATE WA zip 98108 <br /> CONTRACTOR PHONE:206-291-1400 (CONTRACTOR EMAIL:janet.stebbins@jci.com <br /> CONTRACTOR UC.#(REQUIRED):JOHNSCP831 PR CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 050211 <br /> PRIMARY CONTACT: DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: # CONTACT PHONE:206-777-4828 <br /> Janet Stebbins CONTACT EMAIL:janet.stebbins@jci.com <br /> AGREEMENT:I 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 1 am authorized by <br /> the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 <br /> WAC. <br /> City of Everett Official Use Only <br /> PERMIT#: <br /> �f/O 10/04/19 FA (9 10 - �' 3 <br /> 411 erl on e g• t Signature Date (Revised 3/6/2019) <br />