11611 AIRPORT RD 2022-01-11 - Laserfiche WebLink

FIRE SIVPRESSION PERMIT APP•ATION 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 11611 Airport Road PARCEL#: 00537900005300 CITY Everett STATE WA ZIP 98204 SUITE/UNIT#:204 FLOOR#: 2 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):Simutech/Mietzner Business Park CONTACT INFORMATION OWNER NAME:Mietzner Business Park, LLC OWNER MAILING ADDRESS: STREET11611 Airport Road CITY Everett STATE WA ZIP 98204 OWNER PHONE:425-212-2490 OWNER EMAIL:jeffm@MietZnergroUp.001"1"1 CONTRACTOR COMPANY NAME:Mietzner Brothers Properties, LLC WA STATE CONTRACTOR LICENSE#(REQUIRED):MietZbp878Cj CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):5-62 Rear CONTRACTOR ADDRESS: STREET 11611 Airport Road, Suite B1 CITY Everett STATE WA ZIP 98204 CONTRACTOR PHONE:425-212-2490 CONTRACTOR EMAIL:jeffm@mietZnergroup.Com PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR LI OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-754-9653 Jeff M i etzn e r CONTACT EMAIL:jeffm@mietznergroup.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $1 000.00 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: LISFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure DESCRIPTION OF WORK:Move 1 sprinkler head into hallway. TYPE OF INSTALLATION: El New Suppression System ✓❑Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: ❑✓Water Suppression System-#of Heads:10 ❑Chemical Suppression System-#of Heads: NOTE:Application must be submitted with 2 sets of plans,calcs,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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only 3 11 PERMIT# — 0 Owner/Authorized A Si nat e Date (Revised 2/8/2021 )