00-103212• BUIIDING Drv=oN
7 2000 Federal W y, way 8003
Federal Way, WA 98003
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r- - Fax (253)6614129
aE3U1CDING DEpT WH
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: 7 y � -7
PARCEL #
F P s 00 - iO3ZiZ QO -
Commercial Residential ❑
SITE LOCATION
Tenant/ Owner •` �� S
Phone
Address/City/State/Zip t 3 G �n��� �Glre'w /70
Nature of Worti
Project Valuation: $
APPLICANT
Name r� Ae ` -a
Address/City/St/Zip
Contact Person Phone Fax
CONTRACTOR
Company Name - - m
Address/City/SdZip j l` U ('o
Contact Person �°�� � Cher �G� Phon J 3 �'� b F -�-� 3�l Z G� ��
State L & I Contractor Registration # / ? /� �"S� Q / E Date %�
(Card must be presented)
PLEASE SUBMIT THREE (3) SETS OF DRAWINGS AND CUT SHEETS, PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 2411 X 36"
DISCLAIMER: 1 ter*, under penalty ofperjury, that the information furnished by me is tnre and correct to the best ofmy Imowledge and further that I am authorized by the owner ofthe above premises to perform the work
for which permit application is made. I further agree to save hamiless the City of Federal Way as to any claim (including casts, expenses, and attorneys' fees incurred in investigation and defense ofsuch claim), which may be .
made by any person, including the undersigned, and tiled against the City of Federay Way but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of this application
Owner/
FPS.APe
Rms® 5/19/99
G�
C�
Date
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