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Elm <br /> FIRE ALARM PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 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.govlpermits <br /> . PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: LI1 „A( L"0B / BUILDING AREA: sq ft <br /> PROJECT TYPE: 0 NEW CONSTRUCTION 0 ADDITION 14TENANT IMPROVMENT 0 REMODEL <br /> BUILDING USE: 0 SFR 0 TOWNHOUSE 0 DUPLEX 0 ADU 0 MULTI-FAMILY-#OF UNITS: 13,COMMERCIAL <br /> PERMIT INFORMATION.& DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ �,oZ55 ' ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK:W(P___ �(�j �P� •t.QW�„\tT P`Cl�\/Q,(�(1 <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 /> O Location of fire alarm devices <br /> O Battery calculations&voltage drop calculations for notification appliance circuits <br /> O Sequence of operation in either an input/output matrix or narrative form <br /> CONTACT INFORMATION C <br /> OWNER NAME: TENANT BUSINESS NAME(If C. mercial):Tht <br /> OWNER MAILING ADDRESS: STREETQUc'\1 C � \ <br /> CITY /P;� 4 ' STATE <br /> OWNER PHONE: OWNER EMAIL: <br /> • <br /> CONTRACTOR NAME: , al_• Y'~ ' ' <br /> CONTRACTOR ADDRESS: STREET \:: c7: t , , tY - /`� <br /> CIN A��� ' STATE Vv ZIP <br /> CONTRACTOR 0 ., : p CONTRACTOR EMAIL:a`(aatOa" ➢( �f� �l i��\�•�m <br /> CONTRACTOR LIC.#(REQUIREDF-�91,� � CITY OF EVERETT BUSINESS LIC.#(REQI.,rctD)cjJ�-�'�3 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR ROTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:(X)Q) � [6 -^ <br /> 1<Le,To `,�\1 ( CONTACT EMAIL �r 1.(3v A7U\l9Jl'1paf)SISAA ,i_k \ C- ) <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 /> ,,t!ytu, FA �`��2 ,- c� <br /> •'•• •rt uthoriz dAge Signature Date (Revised 4/15/2019) <br />