12-105740CITY OF
Federal Way
COMMUNITY DEVELOPMENT SERVICES a EC EA
LI CAT I O N
253 T FAX 253 - 835 -2609
T Aerabna(r.com
DEC 31 2012
�� - /
SF MF CO ME PL DE EN QP
SITE ADDRESS 600 Sou CITYh0f3F t PA1, -WAY
SUITE /UNIT#
CDS
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 4,000.00
Light Industri
1 9 2 6 5 0 0 _ 0 2 6 0
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION ❑ ENGINEERING l FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeouyner Last Name)
DOW JONES & COMPANY INC
Install pre- action system utilizing 4010ES Panel.
PROJECT DESCRIPTION
Joint venture between SimplexGrinnell and Well Grounded Electric.
Detailed description of work to
be included on this permit only
NAME DOW JONES & COMPANY INC
PR 2! 4Y 51It 77E -8260
PROPERTY OWNER
MAILING ADDRESS
E -MAIL
600 S 334th Street
CITY
STATE
ZIP
Federal Way
WA
I
98003
NAME
PHONE
Wel Grounded Electric
206 - 512 -8001
MAILING ADDRESS 26 Old M Y Way
� '
CONTRACTOR
CITY .. ``'..
Lynnw,Q�`
STATE
WA
ZIP
98087
FAX
O
WAS ONTRACTOR'S LICENSE #
ERPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
J >
WELLGGE963PJ
12/ 27 /14
11- 102742 -00
NAME SimplexGrinnell
PHONE 206- 291 -1400
APPLICANT
MAUINGADDRESS 9520 10th Ave S. Suite 100
'astebbins
@simplexgrinnell.
CITY
Seattle
STATE I
WA
ZIP
98108
FAX
206 - 291 -1500
PROJECT CONTACT
NAME Janet Stebbins /SimplexGrinnell
PHONE 206-291-1468
(The individual to receive and
MADMIG ADDRESS 9520 10th Ave S. Suite 100
jast bbins @simplexgrinnell.
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
Seattle
WA
98108
206 - 291 -1500
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
Rob Slabaugh 206-291-1420
rslabaugh @simplexgrinnell.c
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 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 reliance of the city, including its officers and employees, upon the accuracy of the
irformation supplied to the city as a part of this application.
SIGNATURE: ' DATE 12/29/2012
PRINT N anet Stebbins /SimplexGrinnell
Bulletin #100 - January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application
)m
om
M