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FIRE ALARM PERMIT APPLITION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> SUBMITTAL INSTRUCTIONS: Email application to everetteps@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box <br /> WAStHINGTON CONTACT INFORMATION:(P)425.257.88101(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: $ I' 5 — �� ,Z a1° i LA) BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ ADU ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> PERMIT INFORMATION 8, DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ >I O 0 L` • ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): 4�` // <br /> DESCRIBE SCOPE OF WORK: <br /> , ,j 1 A L-L. ( L�L� L L ti✓l .VI Ai L. : /,CA-i s%G l C e X <br /> Nd/t. 1 i <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 /> ❑ 2 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> ❑2 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: (.' 4-Li t?y c i t_ i; r r j I TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET S S ti �'�-- rv--'�t;vC (_;-,r''< C LA f;� `7." <br /> CITY g- e-1L t" p J STATE (4444 ZIP ���, <br /> OWNER PHONE: 3S5._ $Z// OWNER EMAIL: t: 1� 's ! S,. ." N> CO.5-( <br /> CONTRACTOR NAME: / "' 7 -44 X i,S c} L., tZ J I r <br /> CONTRACTOR ADDRESS:39.20 STREET I/sO ry „! "a.44-t <br /> / ...LPA-% AV CITY Jt/14-� STATE d 93/(i, 21P ,A <br /> CONTRACTOR PHONE: d> 71 L'2-'c+1° CONTRACTOR EMAIL: ,r 1-ft jf-X(; r.S `//L (` <br /> CONTRACTOR LIC.#(REQUIRED);G74 A.f'4 yi ')/1� /'L Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED); , O / <br /> PRIMARY CONTACT: DOWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: zits 7 '7 <br /> 1 : 1 a CONTACT EMAIL: 4i, ,L..4 x 4.,5 e Ale <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 /> Vl FA 2109 -oo�- <br /> 2 <br /> Owner/Authorized Agent Signature Date /k <br /> 9 5 (Ravisod 3l6/2019) <br /> }' <br /> 1� <br />