FIR2021-0122+Application+11.4.2021_12.56.50_PM+2502908CITY OF EDMONDS
Fire Application #1044588 - LifeStance
Applicant
First Name Last Name
Camryn Olivarez
Number Street Apartment or Suite Number
206 Frontaqe Rd N Ste. C
City State Zip
Pacific WA 98047
Contractor
Company Name
FIRE SYSTEMS WEST INC
Number Street
206 Frontaqe Rd N
City State Zip
Pacific WA 98047
State License Number License Expiration Date UBI #
FIRESWI055LW 6/16/2023 600602737
Project Location
Number Street
21727 76TH AVE W
City Zip Code County Parcel Number
EDMONDS 98026 00580700002701
Associated Building Permit Number Tenant Name
LifeStance
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name
Number Street
PO BOX 92129
Last Name or Company Name
HR ACQUISITION I CORPORATION
MyBuildingPermit.com
Company Name
Fire Systems West
E-mail Address
Cam rynO(,@_firesystemswest.com
Phone Number Extension
2538331248 206
Apartment or Suite Number
Suite C
Phone Number Extension
(253) 833-1248
E-mail Address
CamrynO@firesystemswest.com
Floor Number Suite or Room Number
1 Suite C
Apartment or Suite Number
City State Zip
SOUTH LAKE TX 76092
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: 11/4/2021 Submitted By: Camryn Olivarez
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CITY OF EDMONDS Mysu;laingPerrnit.com
Fire Application #1044588 - LifeStance
Project Contact
Company Name: Fire Systems West
Name: Camryn Olivarez Email: CamrynO@firesystemswest.com
Address: C 6 Frontage Rd N Ste. Phone #: 2538331248 206
Pacific WA 98047
Project Type Activity Type Scope of Work
Nonresidential New Fire Alarm
Project Name: LifeStance
Description of Work: Replace existing fire alarm power supply. Run a new notification circuit and install
new notification devices.
Project Details
Transmitter Type
Dual Line Digital Alarm Communicator
Fire System Counts
Number of Devices
Valuation
Fair Market Value of Work
Type of Work
Other
Panel or Power Supply
The work does not involve a new fire alarm panel or
power supply
22
$4,900
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