5901 23RD DR W PROVIDENCE 2023-05-22

• FIRE S'PRESSION PERMIT APPLICATION 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) PermitServices@everettwa.gov I (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 5901 23RD DRIVE W PARCEL#: 01118500000100 CITY EVERETT STATE WA ZIP 98203 SUITE/UNIT#: 105 FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):PROVIDENCE CONTACT INFORMATION OWNER NAME:SEAWAY CORPORATION OWNER MAILING ADDRESS: sTREET4932 NE 97TH ST. CITY SEATTLE STATE WA ZIP 98115 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:FIRE SYSTEMS WEST WA STATE CONTRACTOR LICENSE#(REQUIRED):FIRESW1140B1 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@FIRESYSTEMSWEST.COM PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:253-468-0703 KEV I N RIDER CONTACT EMAIL:KEVINR@FIRESYSTEMSWEST.COM FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $13700 ASSOCIATED PERMIT#(if applicable):B2205-035 (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 NEW FEED FROM EXISTING OVERHEAD SYSTEM TO PROTECT NEW OFFICE AREA. ADD NEW SPRINKLERS FROM EXISTING OVERHEAD SYSTEM TO NEW OXYGEN STORAGE ROOM. TYPE OF INSTALLATION: ❑New Suppression System ❑✓Additions/Alterations to existing suppression system ElOther-Describe above TYPE OF SUPPRESSION: ✓❑Water Suppression System-#of Heads:17 ❑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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only Kevin Rider DDateiitally:2022.0 signed7.2 by608:Kevin56:57 Rider-07'00' 7/26/2022 PERMIT# (/.f0 2 Owner/Authorized Agent Signature Date (Revised 4/21/2022) 4J ' �J