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FIR2021-0062+Application+6.18.2021_3.24.47_PM+2259112CITY OF EDMONDS Fire Application #980063 - Larsen 75th PI Applicant First Name Last Name Brian Setzer Number Street Apartment or Suite Number 15617 Westwick Rd City State Zip Snohomish WA 98290 Contractor Company Name SETZER PLUMBING Number Street 15617 WESTWICK RD City State Zip SNOHOMISH WA 98290 State License Number License Expiration Date UBI # SETZEP*825JL 4/13/2022 604202080 Project Location Number Street 15729 75TH PL W MyBuildingPermit.com Company Name Setzer Plumbinq E-mail Address office(�D_setzerplumbinq.com Phone Number Extension 3605689784 Apartment or Suite Number Phone Number Extension (360) 568-9784 E-mail Address office(cD_setzerplumbinq.com City Zip Code County Parcel Number EDMONDS 98026 00513300002700 Associated Building Permit Number Tenant Name BLD2020-0564 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number First Name Last Name or Company Name Sharon E Larsen Number Street Apartment or Suite Number 9832 MARINE VIEW DR City State Zip MUKILTEO WA 98275 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: 6/18/2021 Submitted By: Brian Setzer Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #980063 - Larsen 75th PI Project Contact Company Name: Setzer Plumbing Name: Travis Setzer Email: office@setzerplumbing.com Address: 15617 Westwick Rd Phone #: 425-754-1515 Snohomish WA 98290 Project Type Single Family Residential Activity Type Scope of Work New Fire Sprinkler Systems Project Name: Larsen 75th PI Description of Work: Flow through Fire sprinkler system Project Details Fire System Type NFPA 13D Page 2 of 2