2121 MADISON ST A 2024-02-28 - Laserfiche WebLink

FIRE ALARM PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:Drop off app'-cation and submittal documents at 3200 Cedar Street 2nd Floor Drop Box WABNINOTON CONTACT INFORMATION:(P)425-257-6810 1(E)PermilServices@everettwa,gov I(W)everettwa.govlpermils PROJECT SITE INFORMATION PROJECT ADDRESS: 2121 Madison St A BUILDING AREA: 100 sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION F✓-_i TENANT IMPROVMENT []REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX CI ADU ❑MULTI-FAMILY-#OF UNITS: ❑✓ COMMERCIAL PERMIT'INFORMATION & DESCRIPTION OF:WORK CONTRACT PRICE OF WORK:$2000.00 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): ��U � •-0.7-.' DESCRIBE SCOPE OF WORK: ADD CELLULAR COMMUNICATION TO EXISITING FIRE ALARM SYSTEM PLAN REVIEW REQUIREMENT Plan review by the Fire Department Is required prior to permit Issuance.Confirm the required items are Included by checking the boxes: Check the boxes below to indicaticate all documents that are being submitted with this permit application: ✓❑ 2 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) 2 Sets of Plans-Must include the following: ❑ Location of fire alarm devices ❑ Battery calculations&voltage drop calculations for notification appliance circuits ❑ Sequence of operation in either an Input/output matrix or narrative form CONTACT IINFORMATION OWNER NAME: TENANT BUSINESS NAME If Commercial):MADISON ST DENTAL CLINIC OWNER MAILING ADDRESS: STREET 2121 MADISON ST A , EVERETT STATE WA Z,P 98203 OWNER PHONE: 425-353-3210 JOWNER EMAIL: IDOCTOR.KIM@FRONTIER.COM CONTRACTOR NAME: BAY ALARM CONTRACTOR ADDRESS: STREET 8229 44TH AVE W, SUITE D c,y MUKILTEO STATE WA Z,, 98275 CONTRACTOR PHONE: 1CONTRACTOR EMAIL: CONTRACTOR LIC.#REQUIRED : BAYALAC876KF ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):57430 PRIMARY CONTACT: ❑OWNER Q✓ CONTRACTOR ❑O1 rIER(Please Specify) CONTACT NAME: CONTACT PHJNE: 425-595-3953 Dianna Williams CONTACT EMAIL: dianna.williams@bayalarm.com AGREEMENT.I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and 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 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 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 WAC. City of Everett Official Use Only PERMIT#: Z-2) FA L,3 6 S Owner/Authorized Agent Signature Date (Revised 4/21/2022)