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PERMIAPPL N
Federal Way
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OCT 07 2015
PERMIT NUMBER 15 _ 1 0 5 1 0 & _ EP CITY OF FEDERAL WAY
_ TARGET DATE CDS
SITE ADDRESS SUITE/UNIT#
27320 Pacific Hwy South-Federal Way,WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 29,500.00 9 7 2 q I Z _ O 0 Z CD
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ENGINEERING'' FIRE PREVENTION
NAME OF PROJECT DaVita Federal Way
Installation of new wet fire sprinkler system beginning from the flange inside the building.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
BFPS, INC 425-388-0124
MAILING ADDRESS E-MAIL
CONTRACTOR PO Box 1110 keith@burnsfire.com
CITY STATE ZIP FAX
Granite Falls WA 98252 360-691-2704
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
BFPSLL*929MA 12 / 31 /2015
NAME PRIMARY PHONE
BFPS, INC 425-239-2698
APPLICANT MAILING ADDRESS E-MAIL
PO Box 1110 keith@burnsfire.com
CITY STATE ZIP FAX
Granite Falls WA 98252 360-691-2704
NAME PRIMARY PHONE
PROJECT CONTACT Keith Kyle 425-239-2698
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence PO Box 1110 keith@burnsfire.com
concerning this application) CITY STATE ZIP FAX
Granite Falls WA 98252 360-691-2704
NAME
PROJECT FINANCING Vtr OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person,including the undersigned, and filed against the city,
but only where such claim arises out of the relian a of the city, including its officers and employees, upon the accuracy of the
information supplied to the city asla part of this ap cation.
SIGNATURE: i/�- u(77 e.., DATE 10/06/2015
PRINT NAME: Keith Kyle
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
