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• • <br /> MEM <br /> ® FIRE ALARM PERMIT , PPLICATIO <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.evereltwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:;•. 5\ 't A ( BUILDING AREA: sq ft <br /> PROJECT TYPE: 0 NEW CONSTRUCTIONVI-ADDITION 0 TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR ❑TOWNHOUSE 0 DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: la COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$L._L c-Ic�' ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK:Tv( C\\(\,( , /-> " I' ' `i a(\/-3k(A\\i‘,`)( kO <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 /> O Location of fire alarm devices <br /> O Battery calculations&voltage drop calculations for notification appliance circuits <br /> 0 Sequence of operation in either an input/output matrix or narrative form <br /> CONTACT INFORMATION . <br /> OWNER NAME: [(��,,��,, TENANT BUSINESS NAME(If Commercial):f <br /> OWNER MAILING ADDRESS: STREET; " •",%?:kAl C • <br /> () �)� <br /> CITY STATE v f c V ZIP `j4A A <br /> OWNER PHONE: L) Kr) - '- )\. �/�OWNER EMAIL: <br /> 1 <br /> CONTRACTOR NAME: " ( 1 ! <br /> CONTRACTOR ADDRESS: STREET <br /> CITY 1 k4& ST TE \ jP ZIP k <br /> n �CONTRACTOR PHONEI CONTRACTOR EMAIL: '�' t `` �(' �/ ' <br /> L �1� ��t�! � ;�i'a��:C�v��;�fit,.� �.i(-Lt -�l�i�tl• � ,�� <br /> CONTRACTOR LIC.#(REQUIRED)( 1 ji k') CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER ' I CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: An LT1%- , ^ <br /> r <br /> r 7 CONTACT EMAIL: "1 D '�-k \IUJ'C�: '\.li � � (� [ i kY\ C.L cn <br /> AGREEMENT:1 hereby certify that/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 1 Z-Z �0 <br /> Owner/Authorized Agant Signature Date (Revised 4/15/2019) <br /> Iy2- <br />