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ORE ALARM PERMIT APPLIcION <br /> V E R E T T 32 CITY OF EVERETT PERMIT SERVICES <br /> 00 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: q I St.() eti.ere - Mail I,)O,Vl BUILDING AREA: sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION El ADDITION ,TENANT IMPROVMENT El REMODEL <br /> BUILDING USE: El SFR El TOWNHOUSE ❑DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ' COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ P.0O0 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): /,exL 2511 <br /> Z <br /> DESCRIBE SCOPE OF WORK: (€place .eXist rhr aia vm eDm,nta4 cicerpr <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 /> Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> ❑3 Sets of Plans-Must include the following: <br /> El Location of fire alarm devices <br /> El 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: ( Q/'jQL(g{°) {f1(X 1 {1C% ENANT BUSINESS NAME(If Commercial): (Le.r.TD(4S <br /> OWNER MAILING ADDRESS: STREET 1 a t4a y 1.47 Mt) <br /> CITY Steatite__ (� STATE & ZIP 7/9 <br /> de- <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: AeCts0 MQV°7YZI Inc <br /> CONTRACTOR ADDRESS: STREET lq02,3 36;1n Ave LL.O`c-f-e <br /> CITY ti tift2 STATE ZIP �1� <br /> // <br /> tag- <br /> CONTRACTOR PHONE: q2 //L 9Lf''CONTRACTOR EMAIL:, j w ii e : ItcpretPabScoso/t.c j onf•ccrY) <br /> CONTRACTOR LIC.#(REQUIRED): s(01-z ?icy CITY OF EVERETT BUSINESS LIC.#(REQUIRED):OL1S(L, <br /> PRIMARY CONTACT: DOWNER / CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 14Zs)-/ /1 'I L 'W Aspna CONTACT EMAIL: ; 1/t Fre & nr(QS( �LSCo SOiu y`cns. C Crn <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 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 /> City of Everett Official Use Only <br /> PERMIT#: <br /> ...�! 242wIiD FA z g <br /> •' ner/d. n�}'��' Signature Date (Revised 3/6/2019) <br /> L <br />