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FIR2020-0105+Application+12.1.2020_9.34.52_AMCITY OF EDMONDS Fire Application #891494 - Windstar Applicant First Name Last Name Jason Duby Number Street 809 E Mountainview Ave City State Zip Ellensburq WA 98926 Contractor Company Name ARROW FIRE PROTECTION LLC Number Street 809 E. MOUNTAINVIEW AVE City State Zip ELLENSBURG WA 98926 MyBuildingPermit.com Company Name ARROW FIRE PROTECTION LLC Apartment or Suite Number E-mail Address arrowid16@gmail.com Phone Number Extension 4253018707 State License Number License Expiration Date UBI # ARROWFP847PK 10/30/2022 604048714 Project Location Apartment or Suite Number Phone Number Extension (425)301-8707 E-mail Address arrowid 16@gmail.com Number Street Floor Number Suite or Room Number 1001 OLYMPIC AVE City Zip Code County Parcel Number EDMONDS 98020 00548900001203 Associated Building Permit Number Tenant Name BLD2018-1267 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name 1001 OLYMPIC AVE LLC Number Street Apartment or Suite Number 20823 NE 150TH ST City State Zip WOODINVILLE WA 98077 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: 12/1/2020 Submitted By: Jason Duby Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #891494 - Windstar Project Contact Company Name: ARROW FIRE PROTECTION LLC Name: Jason Duby Email: arrowjd16@gmail.com Address: 809 E Mountainview Ave Phone #: 4253018707 Ellensburg WA 98926 Project Type Single Family Residential Activity Type Scope of Work New Fire Sprinkler Systems Project Name: Windstar Description of Work: Install 13d system throughout residence Project Details Fire System Type NFPA 13D Page 2 of 2