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Lim SZE ALARM PERMIT APPL•ATION <br /> V E R E T T 32 CITY OF EVERETT PERMIT SERVICES <br /> 00 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 /> 52 <br /> PROJECT SITE INFORMATION <br /> /� <br /> PROJECT ADDRESS: 1 -V w`�N \e\J BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION 17i ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ 500 0)C) ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: \n ,' � I((�( � YYYO'1 I <br /> -09c17 <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�p INFORMATION <br /> OWNER NAME: hre-C\1 S-`�� \'\(�C i ENA,NT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ,L \ CC) \N <br /> CITY VV �Y/. c- STATEVVV:V ZIP 1 <br /> _ <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: �� T C \(3(y\ `jV1\ S�,��- S <br /> CONTRACTOR ADDRESS: STREET \ I .-\ 7 \ I <br /> CITY lJ� STATE v ZIP qs-v 1-I <br /> CONTRACTOR PHONE: 2CA!)--1;522'L -- CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): C� �S CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: I OWNER I CONTRACTOR ]OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: L) -V 72 <br /> Polo\l'-11-) Cs'YLe r CONTACT EMAIL: -e-4f l e If C9,6-NctyCi Y, t � (nt' <br /> AGREEMENT:1 hereby certify that I have read and examined this application and know the same tobe 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 /> 1ti 61\ c ti - O 1-2/n FA7cc - oor- <br /> Owne/Authorized Ag Signature Date (Revised 3/6/2019) <br /> / - <br />