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Fill ALARM PERMIT APPLICARION <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:'•-+��' �/ ('" U S%' \4 A(,) i .2. <br />BUILDING AREA: sq ft <br />PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION qTENANT IMPROVMENT ❑ REMODEL <br />BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: jo COMMERCIAL <br />PERMIT INFORMATION & DESCRIPTION OF WORK <br />CONTRACT PRICE OF WORK: $ <br />ASSOCIATED ELECTRICAL PERMIT # (REQUIRED): <br />DESCRIBE SCOPE OF WORK. ' Y <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): 1'� <br />OWNER MAILING ADDRESS: STREET '-/ A <br />CITY '�"�1; • STATE \ ZIP <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME: u�yl_ e�'� <br />CONTRACTOR ADDRESS: STREET <br />n \ <br />CITY STATE ;v ZIP <br />CONTRACTOR PHONE - <br />CONTRACTOR <br />CONTRACTOR LIC. #(REQUIRED)a '• i 7 �, <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER 000NTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: <br />✓, <br />CONTACT PHONE: - <br />CONTACT EMAIL: <br />J <br />AGREEMENT. !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 />ks <br />17- <br />OAer/Adthorizodt,Agant Mgnature Date <br />City of Everett Official Use Only <br />PERMIT #: <br />(Revised 411512019) <br />Z <br />