2802 BROADWAY VOLUNTEERS OF AMERICA 2022-06-30

FIRE SRPRESSION PERMIT APPLIATION 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 2802 Broadway PARCEL#: 00439166301900 cln, Everett STATE WA ZIP 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):VOA Everett Sparta TI CONTACT INFORMATION OWNER NAME:VOA Western Washington Properties, Corp. OWNER MAILING ADDRESS: STREET PO Box 839 CITY Everett STATE WA ZIP 98206 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:Bums Fire Protection Systems, Inc. WA STATE CONTRACTOR LICENSE#(REQUIRED):BURNSFP841 DU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54660 CONTRACTOR ADDRESS: STREET 15214 116th St NE CITY Arlington STATE WA ZIP 98223 CONTRACTOR PHONE:360-691-2235 CONTRACTOR EMAIL:audra@burnsfire.com PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425-905-5780 CONTACT EMAIL:keith@burnsfire.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK:$ 4-1 I&DO 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: Burns to relocate (1) sprinkler head, remove (5) sprinkler heads and plugging outlets, and adding (7) new pendant heads for new tenant space. TYPE OF INSTALLATION: ❑New Suppression System ©Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: ❑Water Suppression System-#of Heads: ❑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# K Z 0 Z D O Ci)601 )41/SIA Ric31 1 • I* Owner/Authorized Agent Signature Date (Revised 2/8/2021)