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FIR2021-0032_Application_3.31.2021_2.12.16_PM_2121025CITY OF EDMONDS M BuildingPermit.com Fire Application #932477 - Side Door Applicant First Name Last Name Company Name Rachel Brambila Siemens Number Street Apartment or Suite Number E-mail Address 15900 SE EASTGATE Way 200 seattlefireengineering.us@siemens.com City State Zip Phone Number Extension BELLEVUE WA 98008 4252709678 Contractor Company Name Siemens Industry Inc Number Street Apartment or Suite Number 22010 SE 51 st St. City State Zip Phone Number Extension Issaquah WA 98029 425-270-9678 State License Number License Expiration Date UBI # E-mail Address SIEMEII915P1 6/23/2022 R61 gBR56.,i seattlefireengineering.us@siemens.com Project Location Number Street Floor Number Suite or Room Number 750 EDMONDS WAY 1 NONE City Zip Code County Parcel Number EDMONDS 98020 27032500306200 Associated Building Permit Number Tenant Name Sunrise Senior Living Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name HCP INC PROPERTY TAX DEPT Number Street Apartment or Suite Number 1920 MAIN ST 1200 City State Zip I RVI N E CA 92614 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 3/31/2021 Submitted By: Rachel Brambila Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #932477 - Side Door Project Contact Company Siemens Name: Name: Rachel Brambila Email: seattlefireengineering.us@siemens.com Address: 15900 SE EASTGATE Phone #: 4252709678 Way 200 BELLEVUE WA 98008 Project Type Activity Type Scope of Work Nonresidential Alteration Fire Alarm Project Name: Side Door Description of Work: Site is adding a wanderguard system to side door; adding 1 relay to FA system so door will open on alarm event Project Details Fire System Counts Number of Devices 1 Valuation Fair Market Value of Work $4,934 Panel or Power Supply The work does not involve a new fire alarm panel or power supply Page 2 of 2