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• • <br /> FIRE ALARM PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT 3200 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 /> j n r <br /> PROJECT ADDRESS: t i2JJ0 7 �jf ( � r ��. 1 l BUILDING AREA: ` , . ;. sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION VADDITION El TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 31,2 OO ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK:.\(Q CL\C O{' /1-701-3:\UM CYO � (NI AAiJ 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 /> ❑ 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): iQUG�Q <br /> tf <br /> OWNER MAILING ADDRESS: STREET (.-ILR�`,k2) J `� <br /> STATE y�l\ ZIPC J J <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:DXCVC:I( \ ' ) CIAS `c <br /> CONTRACTOR ADDRESS: STREET y <br /> \l*a k.Pj --k ``1 <br /> CITY 1-Y� STATE l/�`v ZIP - 945. <br /> CONTRACTOR PHONEY CONTRACTOR EMAIL:1 o{T'�1; 'V\ov\L l t?l(�CC U t�h�' t_kx <br /> CONTRACTOR LIC.#(REQUIRED) tc f �yCY <br /> m r1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 1,ii,3� mot' <br /> 1 � : <br /> • <br /> PRIMARY CONTACT: ❑OWNER ;$1 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: c��)) \. ., <br /> CONTACT EMAIL I <br /> i1 `LJ:�����i'`'' (`1i y\AQ r ,fa` <br /> 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 <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 /> °q' 'CO <br /> Owner/Authorized A ent SiOature Date (Revised 4/15/2019) <br /> 117 <br />