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1.. <br /> FIRE SPRESSION PERMIT APPLPATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT <br /> SUBMITTAL 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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1422 112th Street SW PARCEL#: 00442900400800 <br /> c,T.r Everett STATE WA ZIP 98204 <br /> SUITE/UNIT#: FLOOR#: 1 ADDITIONAL LOCATION INFORMATION:Kitchen <br /> TENANT/BUSINESS NAME(if non-residential):Seattloe Vision Church <br /> CONTACT INFORMATION <br /> OWNER NAME:Seattle Vision Church <br /> OWNER MAILING ADDRESS: STREET 1422 122th Street <br /> CITY Everett STATE WA ZIP 98204 <br /> OWNER PHONE:2068162864 OWNER EMAIL:kkim1957@gmail.com <br /> CONTRACTOR COMPANY NAME:AleXander Gow Fire <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):ALEXAGF835QB CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 050029 <br /> CONTRACTOR ADDRESS: 5TREET1436 NW 3rd Street <br /> C11-,, Seattle STATE WA ZIP 981 07 <br /> CONTRACTOR PHONE:(206)632-281 0 CONTRACTOR EMAIL:dwall@gowfire.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:2064828858 <br /> Darin Wall CONTACT EMAIL:dwall@gowfire.com <br /> FIRE SUPPRESSION PERMIT INFORMATION <br /> VALUATION OF WORK: $6000 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 /> DESCRIPTION OF WORK: Install Range Guard/Kidde Fire Suppression system into kitchen hood <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: ❑✓Chemical Suppression System-#of Heads:6 <br /> NOTE:Application must be submitted with 2 sets of plans,talcs,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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> ,,,,5/2022 K 2 I J 0 0 1 <br /> Owner/Au •orize A gent Signature Date (Revised 2/8/2021) <br /> Vor <br />