2929 PINE ST KAISER PERMANENTE 2025-03-26

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 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 2929 Pine Street PARCEL#: 00439069503200 cm Everett STATE WA zip 98201 SUITE/UNIT#: FLOOR#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):Kaiser Permanente CONTACT INFORMATION OWNER NAME:Kaiser Foundation Health Plan of Washington OWNER MAILING ADDRESS: STREET 1300 SW 27th St CITY Renton STATE WA ZIP 98057 OWNER PHONE: OWNER EMAIL: CONTRACTOR COMPANY NAME:Burns Fire Protection Systems, Inc. WA STATE CONTRACTOR LICENSE#(REQUIRED):BURNSFP841 DU CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 54660 CONTRACTOR ADDRESS: STREET PO Box 1110 CITY Granite Falls STATE WA ZIP 98252 CONTRACTOR PHONE:360-691-2235 CONTRACTOR EMAIL:audra@burnsfire.com PRIMARY CONTACT: ❑OWNER ✓❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:425 905 5780 Keith Kyle CONTACT EMAIL:keith@burnsfire.com FIRE SUPPRESSION PERMIT INFORMATION VALUATION OF WORK: $7,503 ASSOCIATED PERMIT#(if applicable): (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: 1Commercial ❑Accessory Structure DESCRIPTION OF WORK: Burns to modify existing sprinkler protection to conform with new electric room and duct. Number of heads to be relocated and added does not exceed number of existing heads, there is no hydraulic impact on the original system. Burns to relocate (3) heads, add (4) heads to existing piping and (6) existing heads to be removed. TYPE OF INSTALLATION: ❑New Suppression System ✓❑Additions/Alterations to existing suppression system LiOther-Describe above TYPE OF SUPPRESSION: ❑✓Water Suppression System-#of Heads: c L_1Chemical 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# , 04/04/2022 tc 2_204 Do Owner/Authorized Agent Signature Date (Revised 2/8/2021)