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ORE ALARM PERMIT APPLOATION <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 (W)everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: D(rvJ BUILDING AREA: - -- sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ ADDITION ErTENANT IMPROVMENT ❑REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ,v1ULTl-FAMILY-#OF UNITS: G_ [1COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK: $ 3 -I = ASSOCIATED ELECTRICAL PERMIT# (REQUIRED): <br /> DESCRIBE SCOPE OF WORK:AAr'�� �+ J <br /> V..j.�.1 SI�I1 .AE-S R.0 �a �*r iM�✓1i :^I..L TI�2 1 "� /�lG/'w'1 .?/ 4-e�✓1 'f'U <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 /> ❑ Location of fire alarm devices <br /> ElBattery 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: TENANT BUSINESS NAME (If Commercial): Far s4- •^� �.� � <br /> OWNER MAILING ADDRESS: STREET tie),-3 \ /� 2-5 p(2.rD: v / /� <br /> CITY L�Q STATE L 4 ygf ZIP ( a 2 J <br /> OWNER PHONE: 206-- (v U5—5 OWNER EMAIL: Uv G ( > <br /> CONTRACTOR NAME: 6.1.141-5 E r - rO et-k(U✓\ <br /> CONTRACTOR ADDRESS: STREET 3320 \,J o * vrn Ile-/ -k y Iv /�((�� <br /> CITY ,�v17U ✓� STATE LAJ .� ZIP q L'C I <br /> CONTRACTOR PHONE:1.5 S—f��p1' I (c Z CONTRACTOR EMAIL: 9-v , Aid :4.1 CONTRACTOR LIC.#(REQUIRED): O TAF'90i-1 03 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 51-1 L1 I <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: a . i3S Z i9 6..2._ <br /> --1h )*1 r�Y CONTACT EMAIL: 2y,.,,,, Le 6t <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 /> � FAZ2 j-� <br /> 0 Au�hori d Agent Sign ure Date (Revised 4/21/2022) �. <br /> 1 J ,°'_. <br />