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FIR2024-0121_Application_12.10.2024_10.51.51_AM_4661940CITY OF EDMONDS M BuildingPermit.com Fire Application #1585334 - Edmonds Orthodontics Applicant First Name Last Name Company Name Scott Gehlhausen Brimstone Fire Safety Management LLC Number Street Apartment or Suite Number E-mail Address 3615 132nd St SW STE A Scotty@brimstonefiresafety.com City State Zip Phone Number Extension Lynnwood WA 98087 (425) 502-1836 Contractor Company Name BRIMSTONE FIRE SAFETY MNG LLC Number Street Apartment or Suite Number PO Box 1508 City State Zip Phone Number Extension Woodinville WA 98072 (425) 956-3434 (425) 956-3723 State License Number License Expiration Date UBI # E-mail Address BRIMSFS918KO 5/27/2025 FDgg1RBBD Erica@brimstonefiresafety.com Project Location Number Street Floor Number Suite or Room Number 21920 76TH AVE W 1 none City Zip Code County Parcel Number EDMONDS 98026 00461000202001 Associated Building Permit Number Tenant Name Edmonds Orthodontics Additional Information (i.e. equipment location or special instructions)_ Work Location Property Owner First Name Last Name or Company Name NORTHWEST SOUND PROPERTIES LLC Number Street Apartment or Suite Number 21920 76TH AVE W 201 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: 12/10/2024 Submitted By: Scott Gehlhausen Page 1 of 2 i CITY OF EDMONDS MyBuitdingPermit.com Fire Application #1585334 - Edmonds Orthodontics Project Contact Company Name: Brimstone Fire Safety Management LLC Name: Scott Gehlhausen Email: Scotty@brimstonefiresafety.com Address: 3615 132nd St SW STE A Phone #: (425) 502-1836 Lynnwood WA 98087 Project Type Nonresidential Activity Type Alteration Scope of Work Fire Alarm Project Name: Edmonds Orthodontics Description of Work: Replace existing silent knight 5808 addressable fire alarm panel with new SK-6808 panel. Replace existing AES radio with new 7707 subscriber unit. Project Details Transmitter Type Digital Alarm Communicator With Cellular Back Up Fire System Counts Number of Devices Additional Project Information Alarm panel installation only, no devices. Valuation Fair Market Value of Work Type of Work Other Panel or Power Supply The work involves a new fire alarm panel or power supply Contact Information Owner Email Address K $7,113 info@edmondsorthodontics.com Page 2 of 2