2211 W CASINO RD ACCESS LASER 2021-12-16

NEN FIRE MPPRESSION PERMIT APPLtATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2211 West Casino Road Everett, PARCEL#: 28041400200900 clry Everett STATE WA ZIP 98204 SUITE/UNIT#: 108 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): Access Laser CONTACT INFORMATION OWNER NAME:FLAKE DAVID & MARCIA OWNER MAILING ADDRESS: STREET 10704 64TH PL W CITY MUKILTEO STATE WA ZIP 98275 OWNER PHONE:N/A OWNER EMAIL:N/A CONTRACTOR COMPANY NAME: Reliance Fire Protection WA STATE CONTRACTOR LICENSE#(REQUIRED): RELIAFP102L1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 031095 CONTRACTOR ADDRESS: STREET 8168 304th Ave SE PO Box 428 CITY Preston STATE WA ZIP 98050-0428 CONTRACTOR PHONE: (206)682-6636 CONTRACTOR EMAIL: PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (206)682-6636 Oleg Sergeev CONTACT EMAIL:Oleg@reliancefire.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK:$10,500 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure DESCRIPTION OF WORK: Add pendent concealed sprinklers for new ACT ceiling in RM Production 108 TYPE OF INSTALLATION: ❑New Suppression System ✓❑Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: ❑Water Suppression System-#of Heads:lb /3 ❑Chemical Suppression System-#of Heads: NOTE:Application must be submitted with 2 sets of plans,talcs,cut sheets,etc.See submittal checklist at everettwa.gov/permits for further information. ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with current federal,state,and local law. The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the Building Official before being authorized under any circumstance.I am the owner,or 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 296.200A WAC. City of Everett Official Use Only 9 7- D7- 2/ PERMIT# Owner/Authoriz Agent Signature Date (Revised 2/8/2021) l \