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FIR2021-0126+Application+11.16.2021_8.10.17_AM+2521897CITY OF EDMONDS MyBuildingPermit.com Fire Application #1050366 - SMC Edmonds Basement OR Corridor Applicant First Name Last Name Company Name Janet Stebbins Johnson Controls Number Street Apartment or Suite Number E-mail Address 9520 10th Ave. S Suite 100 ianet.stebbins(@ici.com City State Zip Phone Number Extension Seattle WA 98108 2067774828 Contractor Company Name JOHNSON CONTROLS FIRE PRTTN LP Number Street Apartment or Suite Number 9520 10th Ave. S Suite 100 City State Zip Phone Number Extension Seattle WA 98108 (206) 291-1468 State License Number License Expiration Date UBI # E-mail Address JOHNSCP831 PR 10/6/2023 602113334 ianet.stebbins(aici.com Project Location Number Street Floor Number Suite or Room Number 21601 76TH AVE W Basement Level OR Clean City Zip Code County Parcel Number EDMONDS 98026 00580700002500 Associated Building Permit Number Tenant Name Swedish Medical Center Edmonds Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name PUBLIC HOSPITAL DISTRICT 2 SNOHOMISH CO Number Street Apartment or Suite Number 4710 196TH ST SW City State Zip LYNNWOOD WA 98036-5517 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: 11/16/2021 Submitted By: Janet Stebbins Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Fire Application #1050366 - SMC Edmonds Basement OR Corridor Project Contact Company Name: Johnson Controls Name: Janet Stebbins Email: janet.stebbins@jci.com Address: 9520 10th Ave. S Suite 100 Phone #: 2067774828 Seattle WA 98108 Project Type Activity Type Scope of Work Nonresidential Alteration Fire Alarm Project Name: SMC Edmonds Basement OR Corridor Description of Modify existing fire alarm system SMC Edmonds, Basement Level Operating Rooms Work: Clean Corridor. Add (7) new devices. Joint venture between Johnson Controls Fire Protection and Cochran, Inc. Project Details Fire System Counts Number of Devices 6 Valuation Fair Market Value of Work $8,125 Type of Work Other Panel or Power Supply The work does not involve a new fire alarm panel or power supply Page 2 of 2