Laserfiche WebLink
0 <br />FIRE ALARM PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />EVERETTSUBMITTAL INSTRUCTIONS: Email application to everetteps@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box <br />If", A_-;11G10% CONTACT INFORMATION: (P)425.257.8810 ( (E) everetteps@everettwa.gov I (W) everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: <br />BUILDING AREA: <br />sq ft <br />PROJECT TYPE: NEW CONSTRUCTION Q ADDITION ❑ TENANT IMPROVMENT [I REMODEL <br />BUILDING USE: ❑ SFR ❑ TOWNHOUSE D DUPLEX ❑ ADU CI MULTI -FAMILY - It OF UNITS: <br />F], COMMERCIAL <br />PERMIT INFORMATION & DESCRIPTION OF WORK <br />CONTRACT PENCE OF WORK: $ <br />ASSOCIATED ELECTRICAL PERMIT tt (REQUIRED): <br />DESCRIBE SCOPE OF WORK: New c.. T"1 r 6/V 1,1A <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 indieaticate all documents that are being submitted with this permit application: <br />19 2 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br />Sets of Plans - Must include the following: <br />Location of fire alarm devices <br />Lei/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 />y <br />OWNER NAME: 1r C)L-( 1` w TENANT BUSINESS NAME If Commercial): <br />a <br />OWNER MAILING ADDRESS: STREET <br />cnY F Ue i/i'' STIArE �'' <br />ZIP <br />,OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR NAME: L�ti_�IGr �, ''L <br />CONTRACTOR ADDRESS: STREET _S <br />CffY t-r" t V rY I STATE <br />ZIP <br />CONTRACTOR PHONE: -r - Q `3 CONTRACTOR EMAIL: ftjr6t S Oi-, Li' er" <br />CONTRACTOR LIC. #(REQUIRF=D): Lt y t i3 LY <br />CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: ❑OWNIER C9CONTRACTOR I_]OTHER (Please Specify) <br />CONTACT NAME: <br />r(or LCl---) I )`i �^ <br />CONTACT PHONE:t <br />CONTACT EMAIL:CGGU� S�"�iltd , •,i r""r' <br />AGhEEMENT., i hereby certify that i have read and examined this application and know the same to be true acid 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 />--.---.. �_--� --`" (i-g3Ja <br />Owner/Authorized Agent Signature Date <br />City of Everett Official Use Only <br />PERk41T #: <br />(Revised 31612019) <br />�/Z <br />