12902 19TH AVE SE GENUINE SMILE DENTISTRY 2021-02-23

• • FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 j FAX 425-257-8857 I(E)overettep.>Oeverettwa.gov€ wwtw.,verettwa.gov/permits 5VAkt.. PROJECT SITE INFORMATION PROJECT ADDRESS: \•L°\O'L Qjc,'(\c‘Q,\\ EVAt.c'QC\ '�\W BUILDING AREA: IS0 sgft PROJECT TYPE: 0 NEW CONSTRUCTION ❑ADDITION Ed TENANT IMPROVMENT El REMODEL ,-�! BUILDING USE: ❑SFR El TOWNHOUSE CI DUPLEX El ADU ❑ MULTI-FAMILY-#OF UNITS:__ LYJ COMMERCIAL PERMIT INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$ SoaO ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): b.AWcal\. KQR: ;DESCRIBE SCOPE OF WORK: TLntS't o.\\ �c o. body-ter_ QovJ�C \ o, n(C\TaK, 220. oA ,Q or aCNn V�45 C e w�o�Yh 14\VC c�'v -A o .IS)< PLAN REVIEW REQUIREMENT Plan review by the Fire Department is required prior to permit issuance.Confirm the required items are included by checking the boxes: Check the boxes below to indicaticate all documents that are being submitted with this permit application: '1 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) 3 Sets of Plans-Must include the following: Location of fire alarm devices E4 Battery calculations&voltage drop calculations for notification appliance circuits N Sequence of operation in either an input/output matrix or narrative form CONTACT INFORMATION OWNER NAME:Cie --"Ea. .2 FT,a.Y\ TENANT BUSINESS NAME(If Commercial):C - OWNER MAILING ADDRESS: STneET lk�� ' \ 2.A2 OO A'4Q, ``\` CITY /42-Ce s'IP.rE W f ZIP 40.4,20% OWNER PHONE:Z.06'S S l�6-z 'OWNER EMAIL: L\n`-�Sh y cV.�c�a\0. � •• coW� CONTRACTOR NAME: Cc•aV�a �Y�ctr y��Q'(06 CONTRACTOR ADDRESS: STREET 4)6 \ c c-,'€ CITY `T &0.. _J STATE A/4A ZIP -A\C n\6)(10 CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LUC.#(REQUIRED) Q.O\A.IP:\S\Z.2OS CITY OF EVERETT BUSINESS LIC.#(REOUIRED): SG S 4- • PRIMARY CONTACT: DOWNER LYICON1 RACTOR ❑OTHER(Please Specify) !__ CONTACT NAME: CONTACT PHONE: 20.6 k1 --5 'CONTACT EMAIL: G1nr '-, Cro p,_ 0S o -ti`rj• CSZTN 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 ordinances governing this type of work will be completed whether specified heroin or not. The granting of a permit does not presume to give authority 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 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 WAC. City of Everett Official Use Only PERMIT#: 10041 I R FA i 9 / d - o-Dh, Owner/Authorized Agent Signature Date (Revised 3/6/2019)