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AE ALARM PERMIT APPLI&ION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETT 3200 CEDAR STREET, EVERETT, WA 98201 <br />(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: � �'"l )(L" � t <br />BUILDING AREA: <br />sq ft <br />PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ❑ TENANT IMPROVMENT ELREMODEL <br />BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: 1XCOMMERCIAL <br />PERMIT INFORMATION & DESCRIPTION OF WORK <br />CONTRACT PRICE OF WORK: $ — <br />ASSOCIATED ELECTRICAL PERMIT # (REQUIRED): <br />DESCRIBE SCOPE OF WORK <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): <br />x ~ <br />OWNER MAILING ADDRESS: STREET r <br />CITY STATE ZIP <br />OWNER PHONE: �i <br />OWNER EMAIL: <br />CONTRACTOR NAME: � " J J <br />CONTRACTOR ADDRESS: STREET <br />CITY STATE vv ZIP <br />J• <br />CONTRACTOR PHONE:' <br />CONTRACTOR EMAIL: &' c 17.E <br />CONTRACTOR LIC. #(REQUIRED): ' <br />CITY OF EVERET USINESS LIC. #(REQUIRED): � <br />PRIMARY CONTACT: ❑ OWNER ECONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />Q <br />CONTACT PHONE: g— <br />CONTACT EMAIL: V\,u\r\a <br />AGREEMENT. 1 hereby certify t6t 1 have read and examined this application and know tiie 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 1 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 />0 nerlAuthorized A nt Si ture Date <br />City of Everett Official Use Only <br />PERMIT M <br />FA 2d,2.-OCAS <br />(Revised 411512019) <br />IZ <br />