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FIR2022-0104+Application+10.3.2022_12.54.36_PM+3142222CITY OF EDMONDS MyBuildingPermit.com Fire Application #1210442 - Table For Twelve Applicant First Name Last Name Company Name Darin Wall Alexander Gow Fire Equipment Number Street Apartment or Suite Number E-mail Address 1436 NW 53rd Street dwall(D_gowfire.com City State Zip Phone Number Extension Seattle WA 98107 (206) 632-2810 Contractor Company Name ALEXANDER GOW FIRE EQUIP CO Number Street Apartment or Suite Number 1436 NW 53rd Street City State Zip Phone Number Extension SEATTLE WA 98107 (206)632-2810 State License Number License Expiration Date UBI # E-mail Address ALEXAGF835QB 11/4/2023 601291837 dwall(a_gowfire.com Project Location Number Street Floor Number Suite or Room Number 320 5TH AVE S 1 Kitchen City Zip Code County Parcel Number EDMONDS 98020 27032300413000 Associated Building Permit Number Tenant Name Table For Twelve Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name VOLTSIS VENTURES LLC Number Street Apartment or Suite Number 320 5TH AVE City State Zip EDMONDS WA 98020 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: Darin Wall Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #1210442 - Table For Twelve Project Contact Company Name: Alexander Gow Fire Equipment Name: Darin Wall Email: dwall@gowfire.com Address: 1436 NW 53rd Street Phone #: (206) 632-2810 Seattle WA 98107 Project Type Nonresidential Activity Type New Scope of Work Kitchen Hood and Duct Project Name: Table For Twelve Description of Work: Install Ansul R102 Kitchen Fire Suppression System into kitchen hood Project Details Fire System Counts Total Number of Systems and/or Equipment Additional Project Information Description Contact Information Owner Email Address 1 Install Ansul R102 fire suppression systems into kitchen hood rian@greatergood.com dwall@gowfire.com Page 2 of 2