4918 24TH AVE W 2023-06-22 - Laserfiche WebLink

E FIRE : PRESSION PERMIT APPOCATION CITY OF EVERETT PERMIT SERVICES EVERETTSUBMITTAL 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 4118 2_q r Lt tV UL- PARCEL#: 00 S 61-°►o 0400`k CITY ,F_ (/e ,- 7/ STATE C.(J/4 . ZIP 07 .- SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: `per' 3 TENANT/BUSINESS NAME (if non-residential): CONTACT INFORMATION OWNER NAME: 's.)_( L Lkj r [—"� ( .-4 S l OWNER MAILING ADDRESS: STREET ..'{ /I, l( 1 - , t_ ---5-',e : IQ__ , / 7 CITY >q`i L /rtij 7:1,--,-; STATE L /:* ZIP 9Y2 z.3 OWNER PHONE: -36,z,0 ,- 6,3/-- Jrc," 'Z_ OWNER EMAIL: CONTRACTOR COMPANY NAME: .5(;() -;- 01 z 7 c( rL_ WA STATE CONTRACTOR LICENSE#(REQUIRED):5- //F p ?79,t/rc CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 60 SS CONTRACTOR ADDRESS: STREET if A.....? 1-7CJP�T (() -Li 12L CITY 1 1�0 STATE ti4c V(, ZIP --9 qg,)c CONTRACTOR PHONE: c;ea_-'f_72- i.� c CONTRACTOR EMAIL: 5 Irt_p_Ta are ---n i .2, , PRIMARY CONTACT: )WNER [CONTRACTOR DTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 1'1r1/-?kL.. {J jQ.4.).P-,1 CONTACT EMAIL: j4'I 'T ��r1 ...,"S• _4:2 �J yA�,,. C FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $ /O// 7C'-)O ASSOCIATED PERMIT#(if applicable): 6 i ,c)Q, — 0 e71 7 (Valuation shall include the prevailing fair market fialue of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) BUILDING TYPE: ,FR E'ownhouse [')uplex [ DU Multi-Family-#Units: _ [ ommercial ,ccessory Structure DESCRIPTION OF-WORK: r- tip- tJ ,5::-✓ • L___ rfrt„, ► LL- Ala 1,- , A/ P/ r TYPE OF INSTALLATION:Flew Suppression System -,dditions/Alterations to existing suppression system ►ther-Describe above TYPE OF SUPPRESSION:slater Suppression System-#of Heads: - _I hemical 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 l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. -- City of Everett Official Use Only PERMIT#L__--:///4 / . C7//4/.? / ' © ()) o O 6 Owner utho zed nt Signature Date (Revised 2/8/2021) ,/