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II'' II PERMIT APPLICATI <br /> /,1,r''" BUILDINMECHANICAL/PLUMBING/SIG RINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink.Onlly Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:3623 Hoyt Avenue PROPERTY TAX#:00451401101100 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: SurinderSidhu TENANT BUSINESS NAME(Commercial): <br /> OWNER MAILING ADDRESS: STREET 5131 126th Street SW <br /> clrr Mukilteo STATE WA ZIP 98275 <br /> OWNER PHONE: (503)866-8020 OWNER EMAIL:surindersidhu@hotmail.com <br /> CONTRACTOR NAME:Glacier Fire Protection, LLC <br /> CONTRACTOR ADDRESS: STREET 18802 91st Street Ct E <br /> cmr Bonney LakeSTATE WA ZIP 98391 <br /> CONTRACTOR PHONE:(307)251-1701 CONTRACTOR EMAIL:jakeb@glacierfp.com <br /> CONTRACTOR LICENSE#(REQUIRED):GLACIFP834MJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 58422 <br /> PRIMARY CONTACT: O OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Fire Sprinkler Contractor <br /> CONTACT NAME: CONTACT PHONE:(307)251-1701 <br /> Jake Box CONTACT EMAIL:jakeb@glacierfp.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:N/A Contract Price of Work:$16,600.00 <br /> Proposed Use of Building:multifamily dwelling-residential Heat Source: OGas OElectric OOther <br /> BUILDING USE: OSFR ❑Townhouse ❑Duplex DADU ©Multi-Family-#Units:3 ❑Commercial LAccessory Structure <br /> Type of Project: Z New DAddition ❑Remodel ❑Repair DT.I. QSign OSprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: Provide design and installation of a fire sprinkler system per 13R for a newly constructed triplex. <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures Count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilatio Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not Heat/AC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems Other: Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log ',of Drains Water Heater <br /> SPRINKLER I SUPPRESSION SYSTE Se -•e Ejector or Sump Pump Other: <br /> Water Suppression System No.of Head„ 25 <br /> Chemical Suppression System Jr Na of Head <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm th- 'nformation contai -.herein is true and correct. Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authoriz approved wo and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the. ner,or 1 a :authorized by the owner of this property to perform the work for which application is made, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WA <br /> City of Everett Official Use Only <br /> JakeDigitally signed by Jake Box PERM! #T <br /> Box DN: aJake Box,o=Glaaier Fra Protection,ou, <br /> emaiNer <br /> Date:2019.01.13 11:54:02-0800' 1/13/2018 �� U <br /> - On Li <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) <br />