Fillable CONTRACT PRICE OF WORK: $ (City of Everett)

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CONTRACT PRICE OF WORK: $ (City of Everett)

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CONTRACT PRICE OF WORK: $
o
o
o
Owner/Authorized Agent Signature
Date
(Revised 3/6/2019)
CONTRACTOR ADDRESS:
STREET
Location of fire alarm devices
Battery calculations & voltage drop calculations for notification appliance circuits
Sequence of operation in either an input/output matrix or narrative form
o 3 Sets of Plans - Must include the following:
OWNER MAILING ADDRESS:
STREET
CITY STATE ZIP
TENANT BUSINESS NAME (If Commercial):
OWNER NAME:
o OWNER o CONTRACTOR o OTHER (Please Specify) ___________________________________________
CONTACT EMAIL:
CONTACT PHONE:
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
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 BUSINESS LIC. #(REQUIRED):
CONTRACTOR LIC. #(REQUIRED):
PERMIT INFORMATION & DESCRIPTION OF WORK
CONTACT INFORMATION
o 3 Sets of Specifications for the Devices to be installed (Equipment technical data sheets)
BUILDING USE: o SFR o TOWNHOUSE o DUPLEX o ADU o MULTI-FAMILY - # OF UNITS:_______ o COMMERCIAL
ASSOCIATED ELECTRICAL PERMIT # (REQUIRED):
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:
DESCRIBE SCOPE OF WORK:
PLAN REVIEW REQUIREMENT
FIRE ALARM PERMIT APPLICATION
PROJECT TYPE: o NEW CONSTRUCTION o ADDITION o TENANT IMPROVMENT o REMODEL
(P) 425-257-8810 | FAX 425-257-8857 | (E) everetteps@everettwa.gov | www.everettwa.gov/permits
PROJECT SITE INFORMATION
CITY OF EVERETT PERMIT SERVICES
3200 CEDAR STREET, EVERETT, WA 98201
BUILDING AREA: ______________________sq ft
FA
City of Everett Official Use Only
CITY STATE ZIP
OWNER EMAIL:
CONTRACTOR PHONE:
CONTRACTOR EMAIL:
PERMIT #:
CITY STATE ZIP
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CONTRACT PRICE OF WORK: $ (City of Everett)

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Completed 13 February 2021

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