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Flat ALARM PERMIT APPLIC.ION .3 <br /> CITY OF EVERETT PERMIT SERVICES 7 <br /> EVERETT SUBMITTAL INSTRUCTIONS: Email application to everetteps@everettwa.gov or drop off at 3200 Cedar Street 2nd Floor Drop Box <br /> WASHINGTON CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ',1..(O `ye- F' 'v'{--zi- Fta _ t c- \ BUILDING AREA:_ sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION El TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑ SFR ❑TOWNHOUSE ❑ DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ lP l`� • ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: f t t Gt GlO,t v�� An-0(U.tt ►vt o A t-D 1(�e 4 v� �i F C✓�,>1 <br /> 5 - 0. 0- 00A i;- .. e j oHam✓ ), <br /> Lug•✓u n,tvu,i-- At. W r1._ ! vxiL,,,,,t , -- G <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 /> ❑ 2 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> ❑2 Sets of Plans-Must include the following: <br /> CI Location of fire alarm devices <br /> El 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: /amyl" 'w' S21� ✓•17,Y11I ) TENANT BUSINESS NAME(If Commercial): A-vt,t'(Av-,,,`. <br /> OWNER MAILING ADDRESS: STREET t P:)( 4-rn-,- -C <br /> CITYfi:A/2 kT STATE I.t:A ZIP S.at) 77 <br /> OWNER PHONE: 42 ) 3L1 • } fih OWNER EMAIL: <br /> CONTRACTOR NAME: 6 r•e kys;L,.vv4 <br /> CONTRACTOR ADDRESS: STREET``F )-'to'4 3;z� A S 13 3 <br /> CITY -eM i STATE w A ZIP I <br /> CONTRACTOR PHONE: �( CONTRACTOR EMAIL: 1{0Te-itiret)Y L)-% , <br /> CONTRACTOR LIC.#(REQUIRED): r1CR-nirre2cS-1-5 H J CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 6`i- 14-4 <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 3 l.D }1- -1-5 D. -- <br /> �C tqu O' CONTACT EMAIL: U�' <'k_r Ylt-vc-k P. • 0-61,v` <br /> 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 <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 /> Owner/Authorized Agent Signature Date Ohs_(�---et)a fj (Revised 3/6/2019) <br />