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FIR2022-0103_Application_10.3.2022_10.42.41_AM_3141544CITY OF EDMONDS M BuildingPermit.com Fire Application #1210295 - ACS Surgery Center Applicant First Name Last Name Company Name Richard McCurdy AlarmTech Inc. Number Street Apartment or Suite Number E-mail Address PO Box 186 rich@alarmtechincorporated.com City State Zip Phone Number Extension Mountlake Terrace WA 98043 (425) 775-4208 Contractor Company Name ALARMTECH INC Number Street Apartment or Suite Number 4208 219th st sw City State Zip Phone Number Extension Mountlake Terrace WA 98043 (425) 775-4208 State License Number License Expiration Date UBI # E-mail Address ALARMI*964NR 8/19/2024 RD941nl4R rich@alarmtechincorporated.com Project Location Number Street Floor Number Suite or Room Number 21911 76TH AVE W 1 Suite 106 City Zip Code County Parcel Number EDMONDS 98026 00545500200100 Associated Building Permit Number Tenant Name ACS Surgery Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name * MASTGECH LLC Number Street Apartment or Suite Number 21911 76TH AVE W 100 City State Zip EDMONDS WA 98026 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: 10/3/2022 Submitted By: Richard McCurdy Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #1210295 - ACS Surgery Center Project Contact Company Name: AlarmTech Inc Name: Richard McCurdy Email: rich@alarmtechincorporated.com Address: PO Box 186 Phone #: (425) 775-4208 Mountlake Terrace WA 98043 Project Type Nonresidential Activity Type Alteration Project Name: ACS Surgery Center Description of Work: Add 1 Project Details 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 Contact Information Owner Email Address Scope of Work Fire Alarm 1 $1,000 michael@alarmtechincorporated.com Page 2 of 2