1615 75TH ST SW HOME HEALTH AND HOSPICE 2022-01-24

FIRE SLPRESSION PERMIT APPLI*TION 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 1615 75 St. SW PARCEL#: 28041100101100 CITY Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: 2 ADDITIONAL LOCATION INFORMATION:NW Corner TENANT/BUSINESS NAME(if non-residential):Providence T\H 3..\--\ CONTACT INFORMATION OWNER NAME:Sabey Corporation OWNER MAILING ADDRESS: sTREET1220 Tukwila Internation Blvd. 4th Floor CITY Seattle STATE WA ZIP 98168 OWNER PHONE:206-281-8700 OWNER EMAIL:joes@Sabey.Com CONTRACTOR COMPANY NAME:Fire Systems West WA STATE CONTRACTOR LICENSE#(REQUIRED):FIRESWI140B 1 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 022919 CONTRACTOR ADDRESS: STREET206 Frontage Rd. N, Suite C CITY Pacific STATE WA ZIP 98047 CONTRACTOR PHONE:253-833-1248 CONTRACTOR EMAIL:kevinr p©firesystemswest.Com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-468-0703 Kevin Rider CONTACT EMAIL:kevinr@firesystemswest.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $32,433 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 and relocate sprinklers for new wall and ceiling layout. TYPE OF INSTALLATION: ❑New Suppression System ❑✓Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: [Water Suppression System-#of Heads:93 ❑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 PERMIT# ui;�i ; ;r„-tr; o.o-rt.m K i I 0 �j - 0 03 Kevin Rider ,;,;,,�„-,,;�,;,�,,;-,:; 7-28-2021 0 Owner/Authorized Agent Signature Date (Revised 2/8/2021) '72_