3003 W CASINO RD BLDG 45-04 2023-12-07

FIRE Sti.I'PRESSION PERMIT APPLPATION 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 (W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 3003 West Casino Road PARCEL#: 28041000100200 CITY Everett STATE WA ZIP 98203 SUITE/UNIT#: FLOOR#: Ground Floor ADDITIONAL LOCATION INFORMATION: Building 45-04 TENANT/BUSINESS NAME(if non-residential):Boeing CONTACT INFORMATION OWNER NAME:Boeing Everett Facility OWNER MAILING ADDRESS: STREET3003 West Casino Road CITY Everett STATE WA zip 98203 OWNER PHONE:425-330-1807 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 L 1 CONTRACTOR ❑OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:253 468 0703 Kevin Rider CONTACT EMAIL:kevinr@firesystemswest.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $ `I 6 1 CYce'` 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: Demo existing foam suppression system in existing building. TYPE OF INSTALLATION: ❑New Suppression System ❑Additions/Alterations to existing suppression system ✓❑Other-Describe above TYPE OF SUPPRESSION: Water Suppression System-#of Heads: Chemical Suppression System-#of Heads: NOTE:Application must be submitted with 2 sets of plans,tales,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 Kevin Rider DaDigtea1ly evin 2022 11�30y1K 58 3RIder 08'00' 11 30 2022 PERMIT# - Co Owner/Authorized Agent Signature Date (Revised-1/21/2022) Z