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FIR2023-0070+Application+8.3.2023_1.32.16_PM+3705887CITY OF EDMONDS nnyst,ilaingPermit.com Fire Application #1357331 - VAISVLA RESIDENCE Applicant First Name Last Name Company Name JOHN SHAKESPEARE Eclipse Fire Sprinklers LLC Number Street Apartment or Suite Number E-mail Address 111 8TH AVE N meet.eclipsefire@gmail.com City State Zip Phone Number Extension Alqona WA 98001 (206) 747-3105 Contractor Company Name ECLIPSE FIRE SPRINKLERS LLC Number Street Apartment or Suite Number 111 8th Ave N City State Zip ALGONA WA 98001 State License Number License Expiration Date ECLIPFS783DP 3/17/2024 Project Location Number Street 17125 69TH PL W City Zip Code EDMONDS 98026 Associated Building Permit Number BLD2022-0094 Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number Extension (206) 747-3105 UBI # E-mail Address 604877835 meet.eclipsefire@gmail.com County Parcel Number 01017300001200 Tenant Name Floor Number Suite or Room Number First Name Last Name or Company Name Ricardas & Vaisviliene Teresa Vaisvila Number Street Apartment or Suite Number 17125 69TH PL W City State Zip EDMONDS WA 98026 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: 8/3/2023 Submitted By: JOHN SHAKESPEARE Page 1 of 2 i CITY OF EDMONDS MyBoi[di ngPerrnit.com Fire Application #1357331 - VAISVLA RESIDENCE Project Contact Company Name: Eclipse Fire Sprinklers LLC Name: JOHN SHAKESPEARE Email: meet.eclipsefire@gmail.com Address: 111 8TH AVE N Phone #: (206) 747-3105 Algona WA 98001 Project Type Activity Type Scope of Work Single Family Residential New Fire Sprinkler Systems Project Name: VAISVLA RESIDENCE Description of Work: NEW FLOW -THROUGH FIRE SPRINKLER SYSTME NFPA 13D Project Details Fire System Type NFPA 13D Contact Information Owner Email Address richard.vaisvila@gmail.com Page 2 of 2