916 PACIFIC AVE MRI BUILDING 2024-04-15

i *IRE ALARM PERMIT APPMFATION CITY OF EVERETT PERMIT SERVI� S EVERETT SUBMITTAL INSTRUCTIONS: Drop off application and submittal documents at 3200 Cedar Street 2nd Floor Drop Box wssHiNCTow CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I (W)everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 916 PACIFIC AVE-MAIN BLDG BUILDING AREA: sq ft PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT ❑REMODEL BUILDING USE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: QCOMMERCIAL PERMIT INFORMATION & DESCRIPTION OF WORK CONTRACT PRICE OF WORK: $85,000 ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): DESCRIBE SCOPE OF WORK:RETROFIT OF FIRE ALARM SYSTEM. ALL PANELS AND INITIATING DEVICES WILL BE SWAPPED OUT. ALL EXISTING NOTIFICATION DEVICES WILL REMAIN AS IS. 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: 0 Location of fire alarm devices ❑✓ Battery calculations&voltage drop calculations for notification appliance circuits ElSequence of operation in either an input/output matrix or narrative form CONTACT INFORMATION OWNER NAME:PROVIDENCE HEALTH & SERVICES TENANT BUSINESS NAME(If Commercial): 1OWNER MAILING ADDRESS: STREET916 PACIFIC AVE 1 cm, EVERETT STATE WA ZIP 98201 OWNER PHONE:425-258-7854 OWNER EMAIL:LLOYD.CHRISTENSEN@PROVIDENCE.ORG CONTRACTOR NAME:CONVERGINT TECHNOLOGIES CONTRACTOR ADDRESS: sTREET450 SHATTUCK AVE S SUITE 100 CITY RENTON STATE WA ZIP 98057 CONTRACTOR PHONE:425-591-5815 CONTRACTOR EMAIL:KEVIN.FREY@CONVERGINT.COM 'CONTRACTOR LIC.#(REQUIRED):CONVETL984BQ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):42662 PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME:KEV I N F R EY CONTACT PHONE:425-591-5815 CONTACT EMAIL:KEVIN.FREY@CONVERGINT.COM AGREEMENT:/hereby certify that I 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 Digitally signed by Kev n Frey OW c_us PERMIT#: E key n.hey@ nv rgint.corn, O Gortcergrt OU ProtectMananer, Kevin Fr ON-bevy tare.,,er dtnia 05.12.22 Om ce Ke Fre FA�2-o 6- D LZ Dat.2C22.OS 12 10: 3?0700 Owner/Authorized Agent Signature Date (Revised 4/21/2022) 1 lz