1425 SE EVERETT MALL WAY GAME ON NW 2022-04-01

Nom FIRE SSPRESSION PERMIT APPL•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 (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1425 SW Everett Mall Way PARCEL#: 28051800404600 CITY Everett STATE WA Zlp 98208 SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):GAME ON NW CONTACT INFORMATION OWNER NAME:EVERETT MALL 11 LLC OWNER MAILING ADDRESS: STREET 12411 VENTURA BLVD cn. STUDIO CITY STATE CA ZIP 91604 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:Crown Fire Protection, Inc WA STATE CONTRACTOR LICENSE#(REQUIRED):CROWNFP044LL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 031397 CONTRACTOR ADDRESS: STREET PO BOX 12113 CITY Mill Creek STATE WA ZIP 98082 CONTRACTOR PHONE:425.481.7669 CONTRACTOR EMAIL:cristie@crownfp.com PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425.481.7669 C ri sti e Og land CONTACT EMAIL:cristie@crownfp.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK:$2000 ASSOCIATED PERMIT#(if applicable):B21 10-050 (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: ZCommercial ❑Accessory Structure DESCRIPTION OF WORK: Add 5 pendent fire sprinkler heads and add 5 upright sprinkler heads for a tenant improvement for Game on NW. TYPE OF INSTALLATION: ❑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,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 � • �` .7 /4Z-7/ 1 PERMIT �QD I f to I wner uthorized Agent Signatu Dati —� (Revised 2/8/2021) / .