9612 19TH AVE SE D 2023-12-18 - Laserfiche WebLink

FIRE S' ""'PRESSION PERMIT APP' ' ;ATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: See applicable submittal checklist for submittal requirements and number of copies required for review, WA$HINGTON 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) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET Q \c) tN`P Oil 1 -�) PARCEL #: CITY Everett STATE WA ZIP 98208 SUITE/UNIT #: L LOOR #: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): CONTACT INFORMATION OWNER NAME: Pacific Ridge Homes OWNER MAILING ADDRESS: STIEET17921 Bothell Everett Hwy. Ste 100 CITY Bothell STATE WA Z,, 98012 OWNER PHONE: (425) 438-8444 OWNER EMAIL: CONTRACTOR COMPANY NAME:West Coast Plumbing and Heating, Inc. WA STATE CONTRACTOR LICENSE #(REQUIRED): WESTCCP791 NP CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): �j7 3S CONTRACTOR ADDRESS: STREET 7419 204th St NE ,,Ty Arlington STATE WA ZIP 98223 CONTRACTOR PHONE:360-403-1000 1CONTRACTOR EMAIL: Info@weStCOaStplumbinginc.net PRIMARY CONTACT: ❑ OWNER ❑✓ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Trisha Steffins CONTACT PHONE:360-403-1000 Ext. 4 CONTACT EMAIL:Trisha@westcoastplumbinginc.net FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $5,000.00 ASSOCIATED PERMIT# (if applicable): �f Z Z U 7 (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: New construction 1 3d fire Sprinkler installation 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, 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. 1 am the owner, or / 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 # Owner/Authorized Age4ltgqature Date (Revised 412112022)