1700 13TH ST 3RD FLOOR 2022-05-16

TIRE ALARM PERMIT APPLICATION EVERETT CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 we L 0 BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION 0 TENANT IMPROVMENT ❑ REMODEL BUILDING USE: El SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ✓❑ COMMERCIAL PERMIT INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK:$8000.00 .ASSOCIATED ELECTRICAL PERMIT#(REQUIRED):E2103-069 DESCRIBE SCOPE OF WORK: PEMC D Wing, Level 3, EP Lab TI. Modifying existing fire alarm system (3)devices. Joint venture between Johnson Controls Fire Protection and Cochran, Inc. 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: 0 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) ❑✓ 3 Sets of Plans-Must include the following: 0 Location of fire alarm devices 0 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: Providence Health & Sevices TENANT BUSINESS NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1801 Lind Ave. SW#9016 CITY Renton STATE WA ZIP 98057 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:Johnson Controls Fire Protection CONTRACTOR ADDRESS: STREET9520 10th Ave S. Suite 100 CITY Seattle STATE WA ZIP 98108 CONTRACTOR PHONE:206-291-1400 CONTRACTOR EMAIL:janet.stebbins@jci.com CONTRACTOR LIC.#(REQUIRED):JOHNSCP831 PR CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 050211 PRIMARY CONTACT: DOWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-495-8219 Janet Stebbins CONTACT EMAIL:janet.stebbins@jci.com 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 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 l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#: FAJanet Stebbin / JCr� 6/7/2021 /2jto6 - 0 Owner/A oriz d Agent Si na re� Date (Revised 3/6/2019) Ila