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FIR2020-0083+Application+9.29.2020_12.17.14_PMCITY OF EDMONDS Fire Application #865658 - Driessen Residence Applicant First Name Last Name David Sherepitka Number Street Apartment or Suite Number PO Box 206 City State Zip Puyallup WA 98371 Contractor Company Name CASCADIA FIRE PROTECTION LLC Number Street PO Box 206 MyBuildingPermit.com Company Name CASCADIA FIRE PROTECTION LLC E-mail Address david(�D_cascadiafirepro. com Phone Number Extension 2532023909 Apartment or Suite Number City State Zip Phone Number Extension PUYALLUP WA 98371 (253)202-3909 State License Number License Expiration Date UBI # E-mail Address CASCAFP833L2 6/27/2021 604126260 david(cD_cascadiafirepro.com Project Location Number Street Floor Number Suite or Room Number 9229 OLYMPIC VIEW DR City Zip Code County Parcel Number EDMONDS 98020 27031300101500 Associated Building Permit Number Tenant Name Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Peter Driessen Number Street Apartment or Suite Number 2610 164TH ST SW A434 City State Zip LYNNWOOD WA 98087 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: 9/29/2020 Submitted By: David Sherepitka Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #865658 - Driessen Residence Project Contact Company Name: LAC CADIA FIRE PROTECTION Name: David Sherepitka Email: david@cascadiafirepro.com Address: PO Box 206 Phone #: 2532023909 Puyallup WA 98371 Project Type Single Family Residential Activity Type Scope of Work New Fire Sprinkler Systems Project Name: Driessen Residence Description of Work: Install a new residential fire sprinkler system based on NFPA 13D and City requirements for the new SFR. Project Details Fire System Type NFPA 13D Page 2 of 2