1130 SE EVERETT MALL WAY HOME GOODS 2023-06-22

FIRE SIPRESSION PERMIT APPAPATION 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 1130 Everett Mall Way PARCEL#: 28051800405800 crn, Everett STATE WA ZIP 98208 SUITE/UNIT#: D FLOOR#: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):HomeGoods CONTACT INFORMATION OWNER NAME:PAPF EVERETT LLC OWNER MAILING ADDRESS: STREET 101 LARKSPUR LANDING CIR STE 120 crry LARKSPUR, STATE CS ZIP 94939 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 M O g l a n d CONTACT EMAIL:cristie@crownfp.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK:$30,000 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 El Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure DESCRIPTION OF WORK: Add 212 pendent fire sprinkler heads and 34 upright sprinkler heads for a tenant improvement. Sprinkler riser, branch lines and mains are existing. TYPE OF INSTALLATION: New Suppression System ❑✓Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: ❑✓Water Suppression System-#of Heads:246 ❑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 PERMIT# /( 12/15 ZZ) 2 -- 05 Owner/Au orized Agent ignature Date (Revised 4/21/2022) ✓2_