1010 SE EVERETT MALL WAY NORTHWEST KIDNEY CENTER - EVERETT 2022-03-07

w i FIRE ALARM PERMIT APPLICATION EVERETT WASHINGTON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1010 SE Everett Mall Way, Suites 100,102,104 BUILDING AREA: 10,812 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ✓❑ TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: ✓❑ COMMERCIAL PERMIT INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $ 17,500 ASSOCIATED ELECTRICAL PERMIT # (REQUIRED): DESCRIBE SCOPE OF WORK: Install fire alarm system for new tenant. 2- 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: ✓❑ 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 ✓❑ Battery calculations & voltage drop calculations for notification appliance circuits ❑✓ Sequence of operation in either an input/output matrix or narrative form CONTACT INFORMATION OWNER NAME: TENANT BUSINESS NAME (If Commercial): Northwest Kidney Center OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Signal Services CONTRACTOR ADDRESS:: STREET PO BOX 9537 �/Q CITY Seattle STATE v `/ VA ZIP 98109 CONTRACTOR PHONE: (206) 364-1998 CONTRACTOR EMAIL: harold.signal@gmail.com CONTRACTOR LIC. #(REQUIRED): LYNSEEC099JH CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 55348 PRIMARY CONTACT: [_]OWNER ❑✓ CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: Harold f3efus CONTACT PHONE: (206) 941-6333 CONTACT EMAIL:harold.signal@gmail.com AGREEMENT.I hereby certify that / 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 herein 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 / comply with the State Contractors Law 18.27 RCW and 296.200 WA C. City of Everett Official Use Only PERMIT #: 11/18/2019 FA2D Owner/Authorized Agent Signature Date (Revised 31612019)