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FIR2020-0071+Application+7.27.2020_1.55.44_PMCITY OF EDMONDS nnyst,ilaingPermit.com Fire Application #825887 - Graphte Art Studios Applicant First Name Last Name Company Name Jeff Lervick P L E LLC Number Street Apartment or Suite Number E-mail Address City stanwood Contractor Company Name PLELLC Number po box 72 jlervick(aD_gmail.com State Zip Phone Number Extension WA 98292 (425)508-1755 Street PO BOX 72 City STANWOOD State License Number PLELLLE922CJ Project Location Number Street 202 MAIN ST City EDMONDS Associated Building Permit Number Apartment or Suite Number State Zip Phone Number Extension WA 98292 (425)508-1755 License Expiration Date UBI # E-mail Address 2/11/2022 602788649 Ilervick(a)_gmail.com Zip Code County Parcel Number 98020 00454800101300 Tenant Name Graphite Art Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number 1 none First Name Last Name or Company Name Mary Olson Number Street Apartment or Suite Number 221 2ND AVE N City State Zip EDMONDS WA 98020-3103 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: 7/27/2020 Submitted By: Jeff Lervick Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Fire Application #825887 - Graphte Art Studios Project Contact Company Name: P L E LLC Name: Jeff Lervick Email: jlervick@gmail.com Address: po box 72 Phone #: (425)508-1755 stanwood WA 98292 Project Type Activity Type Scope of Work Nonresidential New Other Systems and Equipment Project Name: Graphte Art Studios Description of Work: Install 6" level U fire line to Riser Room from main with PIV and valves Project Details Fire System Counts Total Number of Systems and/or Equipment 1 Page 2 of 2