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FIRE ALARM PERMIT APPLICATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: Q)411 EVex-0V et 00,vi BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ®ADDITION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ C!!, - _'CIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ ,C)•00 ASSOCIATED ELECTRICAL PERMIT#(REQUI j't) <br /> DESCRIBE SCOPE OF WORK: knstak\ (\D }SES v-Gd O -kc 0-on 1 ' tC' <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 /> ❑ 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 /> CONTACT INFORMATION c , <br /> OWNER NAME: LFT N1N t �(�� �(l�j TENANT BUSINESS NAME(If Commercial)�"�� j(�� <br /> OWNER MAILING ADDRESS: STREET k 12.0 N • i L\"Y) C.CDt Y WVe $ 00 <br /> CITY LOS \/ p 5 STATE ,J.\/ ZIPSq <br /> OWNER PHONE: )2l r 0`1`CASLIC6 OWNER EMAIL: <br /> CONTRACTOR NAME: (a aid\(,`p seC jro S\-1 <br /> CONTRACTOR ADDRESS: STREET Y `1 L\ ,}�,{1� 't Ave' /��^y/�} ( \ <br /> CITY s�-�-/� ,1 `c STATE V V 1 ZIP <br /> CONTRACTOR PHONE: 7_0llJ' ' Lqt; .)Le CONTRACTOR� , EMAIL: C i ler C•}( it(A\C�n iSe(.� f� C err <br /> CONTRACTOR LIC.#(REQUIRED): (-- k ASL'_>-D\ -3 CITY OF EVERETT BUSINESS LIC.#(REQUIRED) OS-1`4 LI <br /> PRIMARY CONTACT: DOWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME:, � CONTACT PHONE: JCI-�.1 -U2SL J e�-t- 2-11 <br /> t117�.� TTY t_�` e'r CONTACT EMAIL: - hcy--cy <br /> guard cii'ZSSeti,htj corn <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 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 /> � - .AA (Rita/16f FAcc1, co � <br /> Owner/Autho)ed Agent Signature Date (Revised 3/6/2019) <br />