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MINN <br /> FIRE ALARM PERMIT APPLICATION <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 I FAX 425-257-8857 1(E)evereileps@evereliwa,gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION:" <br /> PROJECT ADDRESS: Of SoT H st S W 5-rt,. BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITIONS TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR ❑TOWNHOUSE 0 DUPLEX ❑ADU ❑ MULTI-FAMILY-#OF UNITS: �❑COMMERCIAL <br /> PERMIT INFORMATION;.&.DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$ S/oo - ASSOCIATED ELECTRICAL PERMIT#(REQUIRED): <br /> DESCRIBE SCOPE OF WORK: <br /> ADD Au rsLt f V/SVAL APPLi/'1A)CR`a Fc,1L Pr AEA12..1^--• -reN1Aw.ii /►r+P/Lovt=w 3 1 <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 /> ❑3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets) <br /> ❑3 Sets of Plans-Must include the following: <br /> ❑ Location of fire alarm devices <br /> ❑ Battery calculations&voltage drop calculations for notification appliance circuits <br /> 0 Sequence of operation in either an input/output matrix or narrative form <br /> CONTACT INFORMATION <br /> OWNER NAME: 8,2r)r„OELA_ yrfiv4 ,J TENANT BUSINESS NAME(if Commercial): $// )e.`L mAe...Hyile <br /> OWNER MAILING ADDRESS: STREET )71 yc A.) 7oTH 6T ST-E- )i <br /> CITY Z. STATE 4.19 ZIP ),isc)S Z. <br /> OWNER PHONE: /i ZS F3$l )1l(D [OWNER EMAIL: <br /> CONTRACTOR NAME: 1,3*44 Plat: Aral 3ecv21 Ty l�L <br /> CONTRACTOR ADDRESS: STREET Po 13vx371) <br /> CITY A2tr1/Je—Ton) STATE (AA ZIP gii(2 .3 <br /> CONTRACTOR PHONE:NZ< 7NN /N g> CONTRACTOR EMAIL:-3-6 Ff- -3N H f.)Qtr•w1r <br /> CONTRACTOR LIC.#(REQUIRED): 13HFln}}f f34Mt,") CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 5Cto97 <br /> PRIMARY CONTACT: ❑OWN ER �.1— <br /> CONTRACTT ❑OR OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1/2t Zyy tyy <br /> =ef F 3,2,,ssAisj CONTACT EMAIL: —: PFQ_1313 14.IRE-cc-iY <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 slate 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 /> FA 20;09 -o� <br /> Owne u razed Agent Signature Dale (Revised 4/15/2019) <br /> Y2 <br />