7018 BEVERLY BLVD 2022-07-20 - Laserfiche WebLink

FIRE SIOPRESSION PERMIT APPLOATION 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 10 15 13t if el..„1„y 7 PARCEL#: &O 3 O1 Zb O (G00 CITYfE • Ic("✓ STATE 1 V Y ' ZIP { R. ? O SUITE/UNIT#: FLOOR#: 2 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): PAV(=� 5 V F LA;f\& N CONTACT INFORMATION OWNER NAME: PN I'L 91/6 ( L AC 1-1-N1 OWNER MAILING ADDRESS: STREET 10.1S 8 6�\WA—i`7' ( Lyl7 � CITY IG"1��1-�/ t'{ 1 STATE likil(� O( Q r ZIP u 2° 3 OWNER PHONE: 2 0 tG — et W0 —5(e Q 3 OWNER EMAIL: {MN,/FIIs YUQr'(. C" CONTRACTOR COMPANY NAME: IZQi P(lFy( 1n,--) EA-4- WA STATE CONTRACTOR LICENSE#(REQUIRED): a)I Z r f•g 8-7 ,1/w' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 5^I412 --Ir 4'E Q'J CITY Pk'fr u'J P STATE LJ / ZIP ' a J q CONTRACTOR PHONE: CONTRACTOR EMAIL: PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: �/ CONTACT PHONE: Z•�3 - ?�I • 3?I �J L l G1 t, , ()'al"/ L 1✓v � CONTACT EMAIL: (0 Z I (? Pfoiec- v 1'� f 4 c( 7,9kf2b FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $ q) g'7 Z 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: is DDO11✓6 AJ(.- 5y.51-10 4-00 Ntiw"( 1-1-9 4 P/ TYPE OF INSTALLATION: }lew Suppression System ❑Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: //ater Suppression System-#of Heads: 3 y ❑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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only I _ 702( PERMIT# G ` O ner/Authorized gent Signature Date (Revised 2/8/2021) /G