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ORE ALARM PERMIT APPLI►TION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.govI www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 15 SW Everett Mall Way Suites K&L BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION x❑TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR ❑ TOWNHOUSE ❑ DUPLEX El ADU El MULTI-FAMILY-#OF UNITS: ❑x COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ 10,177.00 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: Tenant Improvement to add(1)remote power supply,(1)monitor module for the power supply, <br /> (1)smoke detector above the power supply,(16)ceiling visual strobes&(7)ceiling horn strobes. <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 /> 0 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> 0 3 Sets of Plans-Must include the following: <br /> 0 Location of fire alarm devices <br /> 0 Battery calculations&voltage drop calculations for notification appliance circuits <br /> ❑x Sequence of operation in either an input/output matrix or narrative form <br /> CONTACT INFORMATION <br /> OWNER NAME: Rosen Bel-Kirk Associates,LLC TENANT BUSINESS NAME(If Commercial): Massage Envy <br /> OWNER MAILING ADDRESS: STREET P.O.Box 5003 <br /> c,Tw Bellevue STATE WA ZIP 98009 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Brimstone Fire Safety Management <br /> CONTRACTOR ADDRESS: STREET 20628 Broadway Avenue <br /> c rr Snohomish STATE WA ZIP 98296 <br /> CONTRACTOR PHONE: 425-956-3434 CONTRACTOR EMAIL: fadesign@brimstonefiresafety.com <br /> CONTRACTOR LIC.#(REQUIRED): BRIMSFS902BL CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 47609 <br /> PRIMARY CONTACT: DOWNER ECONTRACTOR ['OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 425-956-3434 <br /> Jere Thompson CONTACT EMAIL: fadesign@brimstonefiresafety.com <br /> AGREEMENT:/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 /> T FA .2O�- ©O S <br /> Owffer/Authorized Agent Signature Date (Revised 3/6/2019) <br />