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FE ALARM PERMIT APPLIIITION <br /> V E R E T T 32 CITY OF EVERETT PERMIT SERVICES <br /> E00 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: QMO"t �J J\ c J C\\ WI-VC N6 25 BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION L:?ADDITION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 500. 00 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: fls) k,\\ s \run bj vfor -1 tX ACP <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 /> El 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 <br /> OWNER NAME: NY TI-ngi fo-s � O \TENANTn BUSINESS` NAME(If Commercial): <br /> G\OWNER MAILING ADDRESS: STREET V ,9Q \U- \" V VN a <br /> CITY 'Ct/ STATE 1 Q ZIP `U`1 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: C—A/(;ordi an ' `2CC S\S DI f l- <br /> CONTRACTOR ADDRESS: STREET n c�_.\,/ '— AV-e. S. `p,�' <br /> CITY ce.v0 � STATE I vv ' 1 ZIP `S1 <br /> CONTRACTOR PHONE:2 )IP CZ-- k-A CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): C'1UPADOc2_,VJ CS CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: DOWNER CONTRACTOR ['OTHER(Please Specify)CONTACT NAME: n n ,/ CONTACT PHONE: __D —�Q22— La .A.A �� ?- 1 <br /> 'I �� �s\{ {X�1 CONTACT EMAIL: e 6c v 1 L y/A i'cm S'C c eorn <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 /> 9)-4/(A7" o2\t1zb FA ZIoo2 —cl <br /> Owner/Au orized Agent Sign ure Date (Revised 3/6/2019) <br />