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<br /> FIRE SUPPRESSION PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> VE * EI T sustofrrAi INSTRUCTIONS:Sege aptobcabin submittal c3:eckitat for submittal requ[rerr+eats and number of coalba required f0I review,
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<br /> WA",-4NO TON teen drop of completed application f ,s in required submittal documents to 3200 Cedar Street 2nd Finer intake Drop Fox.
<br /> CONTACT INFORMATION:(P)425-257- r810 j(E)PermitSonkc s everettwa,gov;(W)everettwa qo a#permzts
<br /> t rots or Black Ink Only please) PROJECT SITE INFORMATION
<br /> PROJECT SITEADDRESS:** STREET G c,re , t, ,. Wal,1 PARCEL#: 28041300103900
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<br /> SUITEILINIT A: FLOOR V: ADDITIONAL LOCATION INFORMATION:
<br /> TENANT1BUSINESS NAME Of non-residential) $,;v-r c :r' 4,vsrk
<br /> CONTACT IN r RATION
<br /> OWNER NAME: QUINTANA ANTHONY M,& DEBORAH G
<br /> OWNER MAILING ADDRESS: STREET PO BOX 23152, FEDERAL WAY, WA 98093 United States
<br /> coy STATE ZIP
<br /> 'OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR COMPANY NAME:<,(-.i'tch.a;";(Va 'I t re, I"(,)"-C LAI O' ,
<br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):. tuba--;5 yis 14,4 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):.2'{(.) 2„,,,
<br /> CONTRACTOR ADDRESS: STREET 1 t b 1 II'Sc.... `1{4 r
<br /> CITY 7 0C"`f 1 G4',¢: / ., , SATE 2 t
<br /> CONTRACTOR PHONE: 's3 SZS t I CONTRACTOR EMAIL: ct..o^ 5e,,,Ac 2,r""sv'Yt d`e; ,coitt,4
<br /> ' PRIMARY CONTACT: ?M`OWNER 1ONTRACTOR El OTHER(Please Specify) a
<br /> 'CONTACT NAME; CONTACT PHONE•c °" c
<br /> � 4'+) ?i)C t CONTACT EMAIL:c .,+c —0? S ✓. e-<cc1^ ''Sby+ ;c,.a. .Ct1✓xR 5'
<br /> ciPPIIit OPPRESSION PERMIT INFORMATION
<br /> VALUATION OF WORK:$ ASSOCIATED PERMIT#(if applicable):
<br /> vakzai+in snug inckute the peevaesm fee market value of ea labor,matee sts.and equ6pment needed to complete Ina work,whether ecfua€ty owl at not)
<br /> BUILDING TYPE: i£SFR ..:'Townhouse LDuplex DADU .7Multi-Family-#Units: OCommercial DAccessory Structure
<br /> DESCRIPTION OF WORK: _
<br /> ,- l,ea=is e ;. ~ivt ,i•'s�-\ >ti r apt G-c...s Yc —t`/, ,1"'( it,,,,„), 1 ,,"' dAe.v. -to f"0"i VR,C
<br /> . 3 r ,,. ,°s ck" :c s e Cn t ,es ` o °,wt c ,r.
<br /> ,,,h "t { , .c.. " , .0, ^ iciwitk+~cud . T e... c -- f`,;-,I,t2
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<br /> TYPE OF INSTALLATION: LNew.Suppression System ©Additions/Alterations to existing suppression system Other-Describe above
<br /> TYPE OF SUPPRESSION: N`Vater Su pression S tem-#of Heads:_ i heroical Su ressi+.tn$stem-#of Heads_ T2.k.G.x
<br /> i' NOTE;Aopllcation must be subs^-tted with 2 sets of Warts,casts,cut sheets,etc.Ste submittal checklist at everettwa.govipermitsfor further information.
<br /> ACKNOWE(J,)GCMENT t haw reviewer/this application and confirm the infomzatsan contained herein is true and correct Worts done pursuant to this permit must comply wail
<br /> cwrr.rst federal,state,and k cst law The gsantsng of a permit only authorizes appravemd work and no deviations therefrom,Deviations must first be authorized In writing from the
<br /> Building tosel ba#ora being awthorfred under any circumstance f em the owner,or Iam authorized by the owner of this property to perform the work for which applicatiort is made,
<br /> and t comer%/aith the State Contractors Low 18 27 ROW and 228,200A WAG
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<br /> City of Everett Lafticiat Use Only
<br /> (p - ? -� PERMIT# K, Z� 0 WJ
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<br /> Owner/Authorise sae Agent Signal:I n Date (Revised 1/2022)
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