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110 <br /> Elm <br /> FIRE ALARM PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:Drop off application and submittal documents at 3200 Cedar Street 2nd Floor Drop Box <br /> WASHINGTON CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:1620 75TH ST SW BUILDING AREA: 2500 sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ElADDITION ❑TENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ECOMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$2300 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: ADDING AN AES RADIO FOR FIRE ALARM COMMUNICATION <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 /> 0 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:KEVIN KACZKA TENANT BUSINESS NAME(If Commercial):ALPINE CLEANING <br /> OWNER MAILING ADDRESS: STREET 1 620 75TH ST SW <br /> C,T., EVERETT STATE WA z,P 98203 <br /> OWNER PHONE:425-348-7387 OWNER EMAIL: <br /> CONTRACTOR NAME:CASCADE ALARM LLC <br /> CONTRACTOR ADDRESS: STREET20452 84TH AVE S <br /> KENT STATE WA zip 98032 <br /> CONTRACTOR PHONE:206-767-5800 CONTRACTOR EMAIL:CSMITH@CASCADEALARM.COM <br /> CONTRACTOR LIC.#(REQUIRED):CASCAAL963JT CITY OF EVERETT BUSINESS LIC.#(REQUIRED):040997 <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT ^ME: CONTACT PHONE:206-767-5800 X 109 <br /> cc - t. frt CONTACT EMAIL:CSMITH@CASCADEALARM.COM <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 /> 'f E�4, FA , ,.D b - coo <br /> Owner/Authorized Agent Signature Dat (Revised 4/21/2022) <br /> Ed o g °S— '/, <br />