11-103432CITY of u 0
Federal Way T\ // PERMIT
COMMUNITY DEVELOPMENT SER ECE 1 v AR) P L I CAT I O N
253 - 835 -2607• FAX 253- 835 -26 9
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SITE ADDRESS
2210 S 320t%� IFEDERALWAY
SUITE /UNIT #
A6
PROJECT VALUATION
ZONING
ASSESSOR'S TAX /PARCEL #
$ 715.00
-
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING a FIRE PREVENTION
NAME OF PROJECT
PfenantName /Homeowner Last Name)
Lazer Quest Inc
PROJECT DESCRIPTION
Replace a failing FA panel and 2 smoke detectors.
Detailed description of work to
be included on this permit only
(Note)Per Fire Deputy Vince Faranda, drawings not necessary for submittal.
NAME
PRIMARY PHONE
PROPERTY OWNER
Lazer Quest Inc
253 - 946 -4500
PARK BYUNG CHAN
MAILING ADDRESS
E -MAIL
+YOUNG SU
2210 S 320th St Ste A6
CITY
Federal Way
STATE
WA
ZIP
98003 13
NAME
PHONE
ADT SECURITY SERVICES
360- 945 -2787
MAILING ADDRESS
E -MAIL
CONTRACTOR
11824 NORTH CREEK PKWY N, ST #105
William @nwpermit.com
CITY
STATE
ZIP
FAX
BOTHELL
WA
98036
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
ADTSES103205
09/25 2011
NAME
PHONE
ADT SECURITY SERVICES
360- 945 -2787
APPLICANT
MAILING ADDRESS
11824 NORTH CREEK PKWY N, ST #105
E -MAIL
William @nwpermit.com
CITY
STATE
ZIP
FAX
BOTHELL
WA
98036
PROJECT CONTACT
NAME
PHONE
(The individual to receive and
William Millhollin
360 - 945 -2787
MAILING ADDRESS
E -MAIL
respond to all correspondence
concerning this application)
1345 Gulf Road
William @nwpermit.com
CITY
STATE
ZIP
FAX
Point Roberts
WA
98281
ALTERNATE CONTACT NAME:
PHONE
E -MAIL
Naida Kahn
Naida @nwpermit.com
PROJECT FINANCING
NAME
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 irtformation 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 reliance of the city, including its officers and employees, upon the accuracy of the
ir(formation supplied to the city as a part of this application.
1 /
SIGNATURE: DATE 40 S 1
PRINT NAME: `
Bulletin #100 —January 1, 2011 ✓ V Page 1 of 3 k: \Handouts\Permit Application