01-103665cYrr aF �- . BUIEDING BIYLSIUN
Jk-JAW
�J _ 33530 First Way South
FFNt ;. :.`_ ` ' ;' i Fe�eval Way, WA 98003
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(253) 661-4000
Fax (253) 661-4129
FIREPROTECTION SYSTEM APPLICATION
Federal Way Business License dumber: J $ - q f - 1 DI R S g- bb - 13L
F P S d I Aa,44(05' as
PARCEL # 6p � ���� Commercialx— Residential ❑
33 SITE LOCATION O � �����&9- �A
TGr✓f1 a vj v e
TenandOwuer J409 kiza e- J Cif �` Q v ,zj Phone J d3 6
AddresslCitylStatelZip 4 L)A P P A ,1 i PI -AAA - 5 tlj -7-C 5 CC) 9C. L L f VV-- 9
Nature of Work I,CI S %ALL_ 629 ) dc-'14 S�d M14 l e I project Valuation: 0 s ti
S YS ; 9 M W 1 i 14 f, D► 4,e!
APPLICANT
NgMe.PIQ��Id
Address/City/St/Zip ZA6QJ4.4 A 9 841-4 _
Contact Person �r �C �1514 Phone 415-3 �� " Zp� Fax - ZS3 "9ZZ-G lS0
CONTRACTOR
Company Name �pi� 1 i �^ l pom
Addres City/StlZip Z 7 � -7 o to AVE- LAS 7-
Contact Parson + I�I.S.0 Phone '�'�- Fax no- Rz- 6glo
State L & I Contractor Registratioa # )PA 01 �eD 9 Exp. Date
(Card must he presented}
PLEASE SUBMT THREE (3) SETS OF DRAWINGS AND CUT SHEETS; PER NFPA STANDARDS.
MAX UM PLAN SHEET SIZE: 24" X 36"
01SCLAim1_ . t ccr*. undo penalty ofpajwy. that She information farms" I]y me is true and cafrect to the bat ofmy lmowicap and fiufhereM I am authorized by the owncrof the above premises Lo perform the ►Jock
fot which 1p mit appllration is made. i Cvitha aWce to aavc h. Td-f4 th< City o( Federa3 Way u fa any daim [including costs, expez S . arrd ab=eys' Ctts roamed in investi tim end defense oCsuch claim), which may be
made by any pr px. including the tmd ersigned, and Sled tg n•i the City of Fedcmy Way LLd enly ►There such claim arises out of the re1mcc ofthe city. hwltrding its officers and employees, upon the accuracy orthe
nfotmation supplied to the city m n put of Lids appl"ati
Owner/Agent Date
M-Ap •
FEvum 511959