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FIRE SUPPRESSION PERMIT APPLICATION 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 1 (E) PermitServices@everettwa.gov I (W) everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 6307 36TH AVE W. BLDG C. PARCEL #: 28040300401300 cm, Everett STATE Washington ZIP 98203 SUITE/UNIT #: FLOOR #: 1 ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): Deluxe CONTACT INFORMATION OWNER NAME: DELUXE OWNER MAILING ADDRESS: STIEET801 S. MARQUETTE AVE CITY MINNEAPOLIS STATE MN ZIP 55402 OWNER PHONE: 612-400-3758 OWNER EMAIL: CONTRACTOR COMPANY NAME:COSCO Fire Protection WA STATE CONTRACTOR LICENSE #(REQUIRED):COSCOFP1 1 ONM CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): 24164 CONTRACTOR ADDRESS: STREET4308 S. 131 ST PL #25 CITY Tukwila STATE WA z, 98168 CONTRACTOR PHONE:206-438-3376 1CONTRACTOR EMAIL:agroom@COSCOfire.com PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: Alexandra Groom CONTACT PHONE:206-438-3376 CONTACT EMAIL:agroom@coscofire.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $ 34,330.00 ASSOCIATED PERMIT# (if applicable): B2304-096 (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: ADD 57 NEW PENDANTS AND 18 NEW ESFR HEADS FOR NEW WALLS AND CEILINGS. TYPE OF INSTALLATION: ❑New Suppression System Z]Additions/Alterations to existing suppression system ❑Other- Describe above TYPE OF SUPPRESSION: Water Suppression System - # of Heads: 75 ❑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: l 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 1 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. ACexandra Groom 08/25/23 Owner/Authorized Agent Signature Date City of Everett Official Use Only PERMIT # (Revised 412112022)