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• FIRE SUPPRESSION 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)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET A,0 c.4+4 s f $ PARCEL#: 001445060 no Spa cuvte cry w A_ STATE ZIP Cr v SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): 4-.s/4(,v `g 4 LA Y CONTACT INFORMATION OWNER NAME:A f2saw e Icut OWNER MAILING ADDRESS: STREET o2 (1 p 4- 4 6-14 Lk) CITY Ly l' II IAJt Q STATE L).k ZIP •gD 3,6 OWNER PHONE:62b0-A541 —.(10 a ,�s OWNER EMAIL: a 5tGL ft i& `, 0) CONTRACTOR COMPANY NAME: M rc C rofe c-1-0 5 (f-�n4 WA STATE CONTRACTOR LICENSE#(REQUIRED): MT/f2 7 p8)Q 1 fY OF EVERETT BUSINESS LICENSE#(REQUIRED): CONTRACTOR ADDRESS: STREET 1�0 b O jc ,2z 2 z ( I /f A ��,/ CITY-�� f!/ STATE G` ' , ZIP ety 'L 512 CONTRACTOR PHONE:05.3) 3I66 w'CONTRACTOR EMAIL:12yrop",ht Ai)Ira Aye profbcI-ot't50y&{-c•41•Covet PRIMARY CONTACT: ❑OWNER )TRACTOR ❑OTHER(Please Specify) CONTACT NAME:-Q ra Vt dud[kite S CONTACT PHONE:on/1 �J` CONTACT EMAIL:� /Drt.1 rt IYLf t rep 1 o-feef ai 5 y.theit• Le wi FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK:$ 3//0067 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fairtnarket 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: 14 cal( Vtew Ct Yr 5p14kk,(ei syclew 4s por .V f--PA (3IO - S a,(OK(" Sy Si 44 TYPE OF INSTALLATIONew Suppression System ❑Additions/Alterations to existing suppression system ❑Other-Describe above TYPE OF SUPPRESSION: alter Suppression System-#of Heads: /% LiChemical 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# Ow r/Authori ed Agent Signature Date (Revised 2/8/2021) AFL—oo(o