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HomeMy WebLinkAboutA_DOMINOES APPLICATION_V1_20170720RentonRegionalFireAuthoritySprinkler/SuppressionOFFICIALUSEONLYSystemInstallationProject#:1055S.GradyWay,Renton,WA98057Pmt#F425-430-7000(Phone)*425-430-7722(Fax)erI.,,,/**Allrequesteditemsmustbeprovidedinordertoprocessthisapplication.**BuildingPermit#(s):___________________________________________NumberofTenants/Buildings:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _PropertyAddressu41(includeBldg#/Suite/Column/etc.):\02L)DescriptionofWorkçIl,4-O\iValueofConstruction:$(J(2...c()BoeingJob#(ifapplicable):______________________________________PropertyOwner:Phone:StreetAddress:________________________________________City/State:_ _ _ ___ _ _ _ ____ _ _ _ ___ _ _ _ _ __Zip:_ _ ___ _ _ _ ____ _ _ _ _Contractor:AL?“-€E-t_ContactPerson:Phone:flp—E2Fax:_ _ _ __ __ __ _ _E-Mail:AlLtp’-&-eGiK1ku.coMStreetAddress:3Q’%)(7J31y.guyty/State:IJcA—Zip:StateContractorsLicense*1:,4L)Stil]IZ?RentnBusinessLicense#:02(Q\TenantName:eiQ‘tz2—Suite/Room:_________________CONTRACTORINFORMATION:WashingtonStateFireSprinklerCertificationstampmustbeincludedonallplansandcalculationsatthetimeofplanssubmittal.RESIDENTIALONLYSYSTEMS:HaveyouacquiredaPlumbingPermitfromtheBuildingDepartmentfortherequiredapprovedbackflowpreventiondevice?PlumbingPermitnumbermustbeprovidedtothisofficepriortoissuanceYesNoN/A(ComboSyst)oftheFireSprinklerpermit.PlumbingPermit#_ _ _ _ ___ _ _ _ ____ _ _ _ ___ _IcertifythattheinformationfurnishedbymeonthisapplicationistrueandcorrectandthattheapplicablerequirementsoftheCityofRentonwillbemet.Iunderstandthatthisapplicationisvalidforsixmonthsfromtheapplicationdate.Ifapermitisnotissuedduringthistimeperiod,thisapplicationwillbecomevoid.Thisapplicationdoesnotconstituteapermittowork.Workisnottocommenceuntilthepermitispostedonpremiseswhereworkistobeperformed.Certificationisherebyrenderedthatnoworkwillbedoneexceptasdescribed,andthatalworkwillnfortotheapplicablecodes.ApplicantSignature:Date:7..2020r1**DoNotWriteBelowThisLine-ForOfficialUseOnly**PlanCheckFee:$__________________________Receipt#:Date:_______________________PermitFee:$______________________________Receipt#:Date:_______________________PlansApprovedContractorDateand(Initial-Date):_______________________________________Contacted:Time:PlansNotApproved(Initial-Date):_____________________________________Form:cRR-o25r(Revised05/11/2017