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FIR2023-0069+Application+7.31.2023_1.09.54_PM+3698145CITY OF EDMONDS MyBuildingPermit.com IF Fire Application #1355705 - ANTHOLOGY OF EDMONDS Applicant First Name Last Name Company Name NISHA TAYLOR PYE BARKER FIRE Number Street Apartment or Suite Number E-mail Address 735 E FAIRHAVEN AVE 265 NISHA.TAYLOR(DPYEBARKERFS.COM City State Zip Phone Number Extension BURLINGTON WA 98233 (360) 755-5444 Contractor Company Name PYE-BARKER FIRE AND SAFETY LLC Number Street Apartment or Suite Number 735 E Fairhaven Ave City State Zip Phone Number Extension Burlinqton WA 98233 (360) 755-5444 (360) 610-9682 State License Number License Expiration Date UBI # E-mail Address PYEBAFS807DO 3/20/2024 604541987 NISHA.TAYLOR(@-PYEBARKERFS.COM Project Location Number Street Floor Number 21200 72ND AVE W MAIN City Zip Code County Parcel Number EDMONDS 98026 00580700000401 Associated Building Permit Number Tenant Name ANTHOLOGY OF EDMONDS Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Suite or Room Number NO First Name Last Name or Company Name CA SENIOR EDMONDS WAS PROPERTY OWNER LLC Number Street Apartment or Suite Number PO BOX 92129 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: 7/31/2023 Submitted By: NISHA TAYLOR Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Fire Application #1355705 - ANTHOLOGY OF EDMONDS Project Contact Company PYE BARKER FIRE Name: Name: NISHA TAYLOR Email: NISHA.TAYLOR@PYEBARKERFS.COM Address: 265 E FAIRHAVEN AVE Phone #: (360) 755-5444 BURLINGTON WA 98233 Project Type Activity Type Scope of Work Nonresidential New Kitchen Hood and Duct Project Name: ANTHOLOGY OF EDMONDS Description of Work: INSTALL ANSUL UL 300 FIRE SUPPRESSION SYSTEM Project Details Fire System Counts Total Number of Systems and/or Equipment 1 Additional Project Information Description Install Ansul UL 300 fire suppression system Contact Information Owner Email Address NA Page 2 of 2