2102 BROADWAY SHELL STATION 2023-07-28

FIRE SIL&RESSION 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 1 (E) everetteps@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2320 California St. PARCEL M 00437866000000 CITY Everett STATE WA ZIP 98201 SUITE/UNIT #: FLOOR #: Basement ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): Snohomish County PUD CONTACT INFORMATION OWNER NAME: Snohomish County PUD OWNER MAILING ADDRESS: STREET PO Box 1107 CITY Everett STATE WA ZIP 98206 OWNER PHONE: 425-783-1000 OWNER EMAIL: CONTRACTOR COMPANY NAME: Western States Fire Protection WA STATE CONTRACTOR LICENSE #(REQUIRED): WESTESF136QF CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 20553 CONTRACTOR ADDRESS: STREET 14690 NE 95th St. Unit 101 CITY Redmond STATE WA ZIP 98052 CONTRACTOR PHONE: 425 881 0100 CONTRACTOR EMAIL: Daniel.Wilke@wsfp.us PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Daniel Wilke CONTACT PHONE: 425 305 2680 CONTACT EMAIL: Daniel. Wilke@wsfp.us FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $ 4430.61 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: Removing existing connection for sprinklers in the elevator pits to the Elevator Machine Room and adding a connection to the main in the Storage area. TYPE OF INSTALLATION: ❑New Suppression System Z Additions/Alterations to existing suppression system ❑Other - Describe above TYPE OF SUPPRESSION: ❑✓ Water Suppression System - # of Heads: 0 ❑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: 1 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. W5 4 Agent Signature 10/18/2021 Date City of Everett Official Use Only PERMIT # KZ 1 1 O _ 00 (Revised 21812021) I/