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FIRE ALARM PERMIT APPL1ATION <br /> EVERETTCITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> WASHINGTON (P)425-257-8810 1 FAX 425-257-8857 1(E)everetteps@everettwa.gov 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:916 Pacific Ave BUILDING AREA: sq ft <br /> PROJECT TYPE: ❑ NEW CONSTRUCTION ❑ADDITION ❑✓ TENANT IMPROVMENT ❑ REMODEL <br /> BUILDING USE: ❑SFR El TOWNHOUSE ❑ DUPLEX El ADU ❑MULTI-FAMILY-#OF UNITS: ✓❑COMMERCIAL <br /> PERMIT INFORMATION & DESCRIPTION OF WORK <br /> CONTRACT PRICE OF WORK:$8112 ASSOCIATED ELECTRICAL PERMIT#(REQUIR D): <br /> DESCRIBE SCOPE OF WORK: <br /> Add (2)duct detectors for Fetal Monitoring Clinic Main Floor. Joint venture between Johnson Controls Fire Protection and <br /> Veca Electric. <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 /> 171 Battery calculations&voltage drop calculations for notification appliance circuits <br /> ❑✓ Sequence of operation in either an input/output matrix or narrative form <br /> CONTACT INFORMATION <br /> OWNER NAME: Providence General Medical TENANT BUSINESS NAME(If Commercial): Providence Regional MC <br /> OWNER MAILING ADDRESS: STREET PO Box 1067 <br /> or( Everett STATE WA zip 98206 <br /> OWNER PHONE:425-261-2000 (OWNER EMAIL: <br /> CONTRACTOR NAME:Johnson Controls Fire Protection <br /> CONTRACTOR ADDRESS: STREET 9520 10th Ave S. Suite 100 <br /> CITY Seattle STATE WA ZIP 98108 <br /> CONTRACTOR PHONE:206-291-1400 (CONTRACTOR EMAIL:janet.stebbins@jci.com <br /> CONTRACTOR LIC.#(REQUIRED):JOHNSCP831 PR CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0'55021 1 <br /> PRIMARY CONTACT: [DOWNER ❑✓CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-777-4828 <br /> Janet Stebbins CONTACT EMAIL:janet.stebbins@jci.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 /> • <br /> N,4 ,�7 94, 1,;'7-‘/ <br /> 4/24/2019 F - A°o4• ner ,1sI ri et Signature Date (Revised <br /> 9 9 3/6/2019) <br />