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FIR2021-0116+Application+10.19.2021_3.51.31_PM+2472121CITY OF EDMONDS nn BtaildingPermit.com Fire Application #1037504 - Sundstone FA for Elevator Modernization Applicant First Name Last Name Company Name Evan Robbins 16D LLC Number Street Apartment or Suite Number E-mail Address PO Box 804 City State Vashon WA Contractor Company Name 16d LLC Number Street 10602 SW 110th ST City Vashon State License Number 16DLLL*882JT Project Location Number Street 1414 9TH AVE N City EDMONDS Associated Building Permit Number evan(.@_16dllc.com Zip Phone Number Extension 98070 2532256025 State Zip WA 98070 License Expiration Date UBI # 5/15/2022 603092523 Apartment or Suite Number PO Box 804 Phone Number Extension (206) 218-4890 (206) 354-0876 E-mail Address shelley(cD_16dllc.com Floor Number All Zip Code County Parcel Number 98020 00427800100100 Tenant Name Core and Elevator Machine Room Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Suite or Room Number Lobbies and First Name Last Name or Company Name Ute Leibrandt Number Street Apartment or Suite Number 1414 9TH AVE N 101 City State Zip EDMONDS WA 98020-2655 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: 10/19/2021 Submitted By: Evan Robbins Page 1 of 2 CITY OF EDMONDS M BuildingPerrnit.com Fire Application #1037504 - Sundstone FA for Elevator Modernization Project Contact Company Name: 16D LLC Name: Evan Robbins Email: evan@16dl1c.com Address: PO Box 804 Phone #: 2532256025 Vashon WA 98070 Project Type Activity Type Scope of Work Nonresidential Alteration Fire Alarm Project Name: Sundstone FA for Elevator Modernization Description of Work: Install a control panel and detection for elevator control. 9 Devices and control panel Project Details Fire System Counts Number of Devices 9 Valuation Fair Market Value of Work $13,500 Type of Work Other Panel or Power Supply The work involves a new fire alarm panel or power supply Page 2 of 2