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F40F ALARM PERMIT flON <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 <br />WASHINr.TnN (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: I 2 ( t' BUILDING AREA: <br />sq ft <br />PROJECT TYPE: ❑ NEW CONSTRU ON G ADDITION ❑ TENANT IMPROVMENT ❑ REMODEL <br />BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: <br />CTCOMMERCIAL <br />PERMIT INFORMATION & DESCRIPTION OF WORK ' <br />CONTRACT PRICE OF WORK: $ ti ( t) a -� ASSOCIATED ELECTRICAL PERMIT # (REQUIRED): <br />DESCRIBE SCOPE OF WORK: ;` a C> m6 E <br />Colh VVtU .4 10 6-nVIL D L <br />M� < a <br />S <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 <br />OWNER NAME: TENANT BUSINESS NAME (if Commercial): 01/ <br />rw <br />OWNER MAILING ADDRESS: STREET <br />CITY STATE <br />ZIP <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: O 001 P9ZT&C__n 0&) <br />CONTRACTOR ADDRESS: STREET 415-2 D dam` +C S Ffe LpC) <br />CITY -a-LE; STATE <br />�j/ <br />ZIP a <br />CONTRACTOR PHONE: Z Z - CONTRACTOR EMAIL: Cr <br />( <br />CONTRACTOR LIC. #(REQUIRED): o J 3 <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />dZL <br />PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />CONTACT PHONE: Z� — 2-( g <br />CONTACT EMAIL: `G <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/ am authorized by <br />the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 <br />WAC. <br />�7 19 <br />Owner/Auth d Agent Signature Date <br />City of Everett Official Use Only <br />PERMIT #: <br />FA <br />(Revised 411512019) <br />