REVIEWED FIR FIR2021-0100+Application+9.10.2021_6.26.37_PM+2403322CITY OF EDMONDS MyBuildingPermit.com
Fire Application #1018351 -Thrive
Kids Dentistry
Applicant
First Name Last Name
Company Name
JERRY MOFFETT
Ace Fire Systems LLC
Number Street
Apartment or Suite Number E-mail Address
PO Box 2065
acefiresystems(D-comcast.net
City State Zip
Phone Number Extension
Buckley WA 98321
2062768872
Contractor
Company Name
Ace Fire System LLC
Number Street
Apartment or Suite Number
P.O. box 2065
City State Zip
Phone Number Extension
Buckley WA 98321
(206) 349-1175
State License Number License Expiration Date
UBI # E-mail Address
ACEFIFS908M3 7/23/2022
603032125 acefiresystems(a_comcast.net
Project Location
Number Street
Floor Number Suite or Room Number
10032 EDMONDS WAY
1 none
City Zip Code
County Parcel Number
EDMONDS 98020
00610700200600
Associated Building Permit Number
Tenant Name
Thrive Dentistry
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
Unknown Unknown
Number Street Apartment or Suite Number
10032 EDMONDS WAY none
City State Zip
EDMONDS WA 98020
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: 9/10/2021 Submitted By: JERRY MOFFETT
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CITY OF EDMONDS MyBui[di ngPerrnit.com
Fire Application #1018351 -Thrive Kids Dentistry
Project Contact
Company Name: Ace Fire Systems LLC
Name: JERRY MOFFETT Email: acefiresystems@comcast.net
Address: PO Box 2065 Phone #: 2062768872
Buckley WA 98321
Project Type Activity Type Scope of Work
Nonresidential Alteration Fire Sprinkler Systems
Project Name: Thrive Kids Dentistry
Description of Work: add one head in med gas closet
Project Details
Fire System Type
NFPA 13
Fire System Counts
Number of Heads Added 1
Valuation
Fair Market Value of Work $1,800
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