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INfitFE ALARM PERMIT APPLI!TIQ 1E, c 7 1E, <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS: Drop off application and submittal documents at 3200 Cedar treet 2nd Floor Drop Box <br /> WASHINGTON CONTACT INFORMATION (P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwv gov/permit'1?3 t <br /> PROJECT SIVEAVIIVIVIVIAT1011. � , <br /> PROJECT ADDRESS:3120 colby avenue I ti I t-A ( i.?� BUILDING AREA: " I -Sq ft <br /> a�tt <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ rr <br /> ADDITION ✓❑TENANT IMPROVMENT a REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> '''*44-4419EIRIOrrINFORNIATIOttltH, *t - * ° 44,4 em s <br /> CONTRACT PRICE OF WORK:$2970 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: <br /> RELOCATE EXISTING FIRE ALARM NOTIFICATION DEVICES AND REPLACE WITH LOW FREQUENCY SOUNDERS <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 /> 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�IN1 ORNMATION <br /> OWNER NAME: SKOTDAL PRIME PROPERTIES TENANT BUSINESS NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET PO BOX 5267 <br /> ci-- EVERETT STATE WA ZIP 98206 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:B&H FIRE AND SECURITY <br /> CONTRACTOR ADDRESS: STREET PO BOX 3711 <br /> ciTr ARLINGTON STATE WA ZIP 98223 <br /> CONTRACTOR PHONE:425-244-1445 CONTRACTOR EMAIL:JEFF@BNHFIRE.COM <br /> CONTRACTOR LIC.#(REQUIRED):BHFIRHF842KW CITY OF EVERETT BUSINESS LIC.#(REQUIRED):055697 <br /> PRIMARY CONTACT: DOWNER ECONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-244-1445 <br /> JEFF BROSSARD CONTACT EMAIL:JEFF@BNHFIRE.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 /> 1 c'3�4 Z 6/8/2023 FA 3 0 0 <br /> Own`/Authorized Agent Signature Date (Revised 4/21/2022) <br /> 1 <br /> 12 <br />