10511 19TH AVE SE CASCADE REHAB 2021-12-13

ftE ALARM PERMIT APPLIC7�TION EVERETT wecu�u r_Tnu 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 05, - PROJECT SITE INFORMATION PROJECT ADDRESS: 49044-19th Avenue SE Suite B BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI -FAMILY - # OF UNITS: 0 COMMERCIAL PERMIT INFORMATION $ DESCRIPTION. OF WORK " CONTRACT PRICE OF WORK: $ 2,704.75 JASSOCIATED ELECTRICAL PERMIT # (REQUIRED): d 2F ' DESCRIBE SCOPE OF WORK: Install one (1) visual strobe in the new patient room. 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: n 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) 3 Sets of Plans - Must include the following: ❑X Location of fire alarm devices IN 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: Kosnik Family, LLC TENANT BUSINESS NAME (If Commercial): Cascade Rehab Assoc. Clinic OWNER MAILING ADDRESS: STREET 46941 9th Avenue SE CITY Everett STATE WA zip 98208 OWNER PHONE: JOWNER EMAIL: CONTRACTOR NAME: Brimstone Fire Safety Management CONTRACTOR ADDRESS: STREET 20628 Broadway Avenue CITY Snohomish STATE WA zip 98296 CONTRACTOR PHONE: 425-956-3434 1CONTRACTOR EMAIL: fadesign@brimstonefiresafey.com CONTRACTOR LIC. #(REQUIRED): BRIMSFS902BL CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 47609 PRIMARY CONTACT: DOWNER OCONTRACTOR DOTHER (Please Specify) CONTACT NAME: Jere Thompson CONTACT PHONE: 425-956-3434 CONTACT EMAIL: fadesign@brimstonefiresafety.com AGREEMENT.- l hereby certify that I 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT #: T 12 April 2021 I FA I`y 4_ 605 Ow r/Authorized Agent Signature Date (Revised 31612019)