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FIRE SUPPRESSION PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETTSUBMITTAL INSTRUCTIONS:See applicable submittal checklist for submittal requirements and number of copies required for review, <br /> WASHINGTON then drop off completed application plus all required submittal documents to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> CONTACT INFORMATION:(P)425.257.8810 1(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 6307 36TH AVE.W. PARCEL#: 28040300401300 <br /> CITY EVERETT STATE WA ZIP 98203 <br /> SUITE/UNIT#: BLDG C FLOOR M 1 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):POWDERMILL BLDG C TI <br /> CONTACT INFORMATION <br /> OWNER NAME:POWDER PHASE 1 LLC <br /> OWNER MAILING ADDRESS: ITREET6840 FORT DENT WAY SUITE 350 <br /> CITY SEATTLE STATE WA ZIP 98188 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR COMPANY NAME:ARCHER CONSTRUCTION <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):ARCHEI'219DR CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 36712 <br /> CONTRACTOR ADDRESS: STREET 7855 S 206TH ST <br /> CITY KENT STATE WA ZIP 98032 <br /> CONTRACTOR PHONE:253-872-7222 CONTRACTOR EMAIL:PERMITS@ARCHERCONSTRUCTION.COM <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253-951-7049 <br /> RICHARD M CONTACT EMAIL:RMALCHEVSKIY@ARCHERCONSTRUCTION.COM <br /> FIRE SUPPRESSION PERMIT INFORMATION <br /> VALUATION OF WORK:$4073 ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> BUILDING TYPE: ❑SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi-Family-#Units: ❑✓Commercial ❑Accessory Structure <br /> DEscRIPTIONOFwoRK:ADD NEW REQUIRED SPRINKLERS TO ACCOMMODATE NEW CEILING AND <br /> WALL LOCATIONS / RELOCATE EXISTING DRAIN TO NEW LOCATION. <br /> TYPE OF INSTALLATION: ❑New Suppression System ❑✓Additions/Alterations to existing suppression system ❑Other-Describe above <br /> TYPE OF SUPPRESSION: ❑✓Water Suppression System-#of Heads:7 ❑Chemical Suppression System-#of Heads: <br /> NOTE:Application must be submitted with 2 sets of plans,calcs,cut sheets,etc.See submittal checklist at everettwa.gov/permits for further information. <br /> 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 <br /> 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 <br /> 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, <br /> and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br />