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FIR2024-0072+Application+8.27.2024_8.15.59_AM+4464178CITY OF EDMONDS MyBuildingPermit.com Fire Application #1538481 - South Hill Pain & Wellness Applicant First Name Last Name Company Name Joe Stevenson Sterlinq Communication Technoloqies Number Street Apartment or Suite Number E-mail Address 825 NW Sacajawea PI joestevenson(abstercommtech.com City State Zip Phone Number Extension Camas WA 98607 (360) 821-6500 Contractor Company Name EVERGREEN TECHNOLOGIES INC Number Street Apartment or Suite Number 3623 E Marginal Way S City State Zip Phone Number Extension Seattle WA 98134 (206) 510-1546 State License Number License Expiration Date UBI # E-mail Address EVERGTI929K9 5/22/2026 602821961 kjmaes(cDevergreentech.com Project Location Number Street Floor Number 21701 76TH AVE W 1 City Zip Code County Parcel Number EDMONDS 98026 00580700002702 Associated Building Permit Number Tenant Name South Hill Pain & Wellness Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Number Street PO BOX 92129 Last Name or Company Name HR ACQUISITION I CORPORATION Suite or Room Number 104 Apartment or Suite Number City State Zip SOUTHLAKE TX 76092 Certification Statement - The applicant states: 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. 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: 8/27/2024 Submitted By: Joe Stevenson Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Fire Application #1538481 - South Hill Pain & Wellness Project Contact Company Name: Sterling Communication Technologies Name: Joe Stevenson Email: joestevenson@stercommtech.com Address: 825 NW Sacajawea PI Phone #: (360) 821-6500 Camas WA 98607 Project Type Activity Type Scope of Work Nonresidential Alteration Fire Alarm Project Name: South Hill Pain & Wellness Description of Work: Installation of required notification for TI remodel of Suite 104 Project Details Transmitter Type Dual Line Digital Alarm Communicator Fire System Counts Number of Devices 10 Valuation Fair Market Value of Work $9,500 Type of Work Other Panel or Power Supply The work involves a new fire alarm panel or power supply Contact Information Owner Email Address joestevenson@stercommtech.com Page 2 of 2