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FIRE ALARM PERMIT APPLICATION <br /> CITY OF EVEC ETT PERMIT SERVICES <br /> E Y,/E R E T T SUBMITTAL INSTRUCTIONS:Drop off application(Hand submittal documents at 3200 Cedar Street 2nd Floor Drop Box <br /> WASHINGTON CONTACT INFORMATION:(P)425-257-8810 it(E)PermitServices@everettwa.gov i(W)everettwa.gov/permits <br /> PROJECT SITE NFORMATION' <br /> PROJECT ADDRESS: 3229 Hoyt Ave BUILDING AREA: 100 sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT ❑REMODEL <br /> BUILDINGUSE: ❑SFR ❑TOWNHOUSE ❑DUPLEX ❑AbU ❑MULTI-FAMILY-#OF UNITS: QCOMMERCIAL <br /> PERMIT INFORMATION ,& ESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$1250 ASSOCIA ED ELECTRICAL PERMIT#(REQUIRED):E2406-077 <br /> DESCRIBE SCOPE OF WORK: installation of cellul r communicator on existing fire/burg system <br /> PLAN REVIEW OEQUIREMENT <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 /> ❑ Battery calculations&voltage drop calculations for notification appliance circuits <br /> ❑ Sequence of operation in either an input/output matl,ix or narrative form <br /> CONTACT INFORMATION <br /> OWNER NAME:Oy TENANT OLISINESS NAME(If Commercial):OM3 Oral Surgery <br /> OWNER MAILING ADDRESS: STREET 3229 Hoyt Ave <br /> c,Ty Everett STATE WA Z,P 98201 <br /> OWNER PHONE:425-408-1652 OWNER EMAIL:senoc@om3surgery.com <br /> CONTRACTOR NAME:Bay Alarm Company <br /> CONTRACTOR ADDRESS: ST1EET8229 44th Ave W, Suite D <br /> c„Y Mukilteo STATE WA ZIP 98275 <br /> CONTRACTOR PHONE:425-595-3953 1CONTRACTOR EMAIL:DIANNA.WILLIAMS@BAYALARM.COM <br /> CONTRACTOR LIC.#(REQUIRED): BAYALAC876KF CI OF EVERETT BUSINESS LIC.#(REQUIRED):57430 <br /> PRIMARY CONTACT: []OWNER ❑✓ CONTRACTOR ❑OTHER('lease Specify) <br /> CONTACT NAME: CONTACT PHONE: 25-595-3953 <br /> Dianna Williams CONTACT EMAIL: d anna.williams@bayalarm.com <br /> AGREEMENT.•I hereby certify that/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 f erein 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 /> alo-� � FA <br /> Owner/Authorized Agent Signature Date (Revised 412112022) <br />