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FIR2023-0060+Application+6.13.2023_10.15.57_AM+3605529CITY OF EDMONDS Fire Application #1330838 - Molly Moon's Applicant First Name Last Name Kathi O'Rear MyBuildingPermit.com Company Name Northwest Fire Systems LLC Number Street Apartment or Suite Number E-mail Address 22645 83rd Ave S Bldq D City State Zip Kent WA 98032 Contractor Company Name Northwest Fire Systems LLC Number Street 22645 83rd Ave. S City State Zip Kent WA 98032 State License Number License Expiration Date UBI # NORTHFS928CR 2/20/2024 602799167 Project Location Number Street 558 MAIN ST korear(cD_nwfiresystems.com Phone Number Extension (206) 772-7502 Apartment or Suite Number BLDG D Phone Number Extension (253) 345-2353 (206) 772-7502 E-mail Address korear(a)_nwfiresystems.com City Zip Code County Parcel Number EDMONDS 98020 00434212001500 Associated Building Permit Number Tenant Name Molly Moon's Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Floor Number Suite or Room Number 1 st 104 First Name Last Name or Company Name SEATTLE-SNOHOMISH MILL COMPANY INC Number Street Apartment or Suite Number 9525 AIRPORT WAY City State Zip SNOHOMISH WA 98296 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: 6/13/2023 Submitted By: Kathi O'Rear Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrnit.com Fire Application #1330838 - Molly Moon's Project Contact Company Name: Northwest Fire Systems LLC Name: Kathi O'Rear Email: korear@nwfiresystems.com Address: 22645 83rd Ave S Bldg D Phone #: (206) 772-7502 Kent WA 98032 Project Type Activity Type Scope of Work Nonresidential Alteration Fire Sprinkler Systems Project Name: Molly Moon's Description of Work: Fire sprinkler TI; add/relocate 6 sprinkler heads for new tenant. Project Details Fire System Type NFPA 13 Fire System Counts Number of Heads Added 6 Valuation Fair Market Value of Work $4,461 Contact Information Owner Email Address korear@nwfiresystems.com Page 2 of 2