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FIR2024-0085_Application_9.18.2024_1.27.36_PM_4508697CITY OF EDMONDS M BuildingPermit.com Fire Application #1549443 - Verdant Health Commissions Fire Alarm Communicator Applicant First Name Last Name Company Name Elisabeth Swidecki Securitas Technology Number Street Apartment or Suite Number E-mail Address 4500 3RD AVE SE SUITE 1 elisabeth.swidecki@securitas.com City State Zip Phone Number Extension Lacey WA 98503 (360) 489-8612 Contractor Company Name Securitas Technology Corp Number Street Apartment or Suite Number 4500 3rd AVE SE 1 City State Zip Phone Number Extension Lacey WA 98503 (360) 489-8612 State License Number License Expiration Date UBI # E-mail Address SECURTC772D1 3/17/2025 FDg4D4gsl elisabeth.swidecki@sbdinc.com Project Location Number Street Floor Number Suite or Room Number 21558 HIGHWAY 99 1 100 City Zip Code County Parcel Number EDMONDS 98026 00580700002201 Associated Building Permit Number Tenant Name Verdant Health Commissions Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name PUBLIC HOSPITAL DISTRICT 2 SNOHOMISH CO Number Street Apartment or Suite Number 4710 196TH ST SW City State Zip LYNNWOOD WA 98036 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: 9/18/2024 Submitted By: Elisabeth Swidecki Page 1 of 2 i CITY OF EDMONDS MyBuildingPermit.com Fire Application #1549443 - Verdant Health Commissions Fire Alarm Communicator Project Contact Company Name: Securitas Technology Name: Elisabeth Swidecki Email: elisabeth.swidecki@securitas.com Address: 4500 3RD AVE SE SUITE Phone #: (360) 489-8612 Lacey WA 98503 Project Type Nonresidential Activity Type Alteration Scope of Work Fire Alarm Project Name: Verdant Health Commissions Fire Alarm Communicator Description of Adding a new DMP CELLCOMF-LTE-V to the existing DMP XT30 fire system at the above Work: listed location. Removing all burg points from the system to set this up as a standalone fire system per AHJ request. Project Details Transmitter Type Dual Line Digital Alarm Communicator Fire System Counts Number of Devices Valuation Fair Market Value of Work Type of Work Other Panel or Power Supply The work does not involve a new fire alarm panel or power supply Contact Information Owner Email Address 1 $4,249 jimf@jshproperties.com Page 2 of 2