10521 19TH AVE SE ALLIED TELESIS INC 2025-03-27

FIRE APPRESSION PERMIT APPLtATION 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 10521 19TH AVE SE PARCEL#: 28052000203000 ciTv EVERETT STATE WA ZIP 98202 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION:FLOOR 2 TENANT/BUSINESS NAME(if non-residential):ALLIED TELESIS CONTACT INFORMATION OWNER NAME:ALLIED TELESIS INC OWNER MAILING ADDRESS: STREET3041 ORCHARD PKWY clry SAN JOSE STATE CA ZIP 95134 OWNER PHONE: OWNER EMAIL:doug_barga@alliedtelesis.com CONTRACTOR COMPANY NAME:COLUMBIA FIRE WA STATE CONTRACTOR LICENSE#(REQUIRED):COLU MFL795NJ CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 048229 CONTRACTOR ADDRESS: STREET 111 S FINDLAY ST crry SEATTLE STATE WA ZIP 98108 CONTRACTOR PHONE:206 232 8569 CONTRACTOR EMAIL:IUke@columbiafire.net PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206 232 8569 Luke Thompson CONTACTEMAIL:Iuke@columbiafire.net FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $15730 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:TI: Adding and relocating sprinkler heads for the new walls and ceilings to comply with NFPA#13-2016 and City of Everett standards. TYPE OF INSTALLATION: ❑New Suppression System ❑Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: ❑✓Water Suppression System-#of Heads:58 ❑Chemical Suppression System-#of Heads: NOTE:Application must be submitted with 2 sets of plans,talcs,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 Div 7 .� 0249/2023 PERMIT# Owner/Authorized Agent Signature Date (Revised 4/21/2022)