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iz FIDE ALARM PERMIT APPLIOTION <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 /> BUILDING AREA: J a� <br /> PROJECT ADDRESS: ��vA MGDpbK�k�! �qe, �ef '�� I �/ �� sq ft <br /> PROJECT TYPE: El NEW CONSTRUCTION L [ADDITION El TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR El TOWNHOUSE ❑ DUPLEX ❑ADU El MULTI-FAMILY-#OF UNITS: 5r COMMERCIAL <br /> PERMIT.INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 1 J 000 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): S :rini "-ttQJ. <br /> DESCRIBE SCOPE OF WORK: PIaG X s-,J..'`. ,,'" C;ry c\c - 0f>c1ro\ �QG \ <br /> r(`�lorv:Arvrd a c c.. 00. r,V-E(?C st v,w AT) C ( \.pr' o;..,c_c&*\cC\ t: S $ . ... Nwk„) <br /> -QC.? h\\\\ lae, <. c c' ''tSc . `t, C v \g'k ("ocevorw \CCU' . 4-v CA_ r o . <br /> C '" c c o,_ 'ki,` \,,f t,r* C eA ! V,,_,l C r7Yi1 mm 1C\\cCt r'"". <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: I(`n► 1,\\?c,,,OrTte(51 AIPACCAbinASTENANT BUSINESS NAME(If Commercial):mm ?J a..ky)g s tI pry,co),:i4 5 <br /> OWNER MAILING ADDRESS: STREET Z .�1-(, 01(1 ps &t.k k <br /> CITY fie,'e � c! STATE „)A ZIP k <br /> OWNER PHONE: 9�S---15 i-{- '"(_p C iZ) OWNER EMAIL: 11 A- <br /> CONTRACTOR NAME: snn\k^CCA FCC' tc(C" <br /> CONTRACTOR ADDRESS: STREET ..-` (c\ t.terir VI,tsf <br /> CITY V ve i t?A STATE t.3 ZIP <br /> CONTRACTOR PHONE: Lip..5-..5.9?, q4,5 CONTRACTOR EMAIL: i,c,,{\,Q 6@ l A .ed V:ie c,>ie?c � - C60 <br /> CONTRACTOR LIC.#(REQUIRED): SON)"C{ ct 9 S DI" CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ‘L , <br /> PRIMARY CONTACT: DOWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: <br /> ' CONTACT PHONE: L� a.0 — �J✓r-'' j` !ate ---CI---CICo 5—.1 t <br /> V evar\ , y � CONTACT EMAIL: att a. S?t �-Utu k'�"i' ?ear,' Dta - _'n'f''C'05 . £.) <br /> AGREEMENT:I hereby certify that 1 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 /> FA 2ol ID -c90 2__, <br /> Owner/Authorized Agent Signa re -,2/ Date (Revised 3/6/2019) <br /> 4-1 <br />