12-105155CITY OF GEZV PERMIT
Federal Wagj
COM3 f5-26 EVEIAPMENT SERVICES 1 41?PLICATION
253 - 835 -2607• FAX 253 - 835 -2609
rururu.cituorfcdernlman.corn �01 WAX
`I �(' Zv _.•mot OF FED �� Y,
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SF MF CO ME PL DE EN FP
SITE ADDRESS
SUITE /UNIT#
34-1-6 S. 348th Street, Federal Way, WA 98003
Building "A"
PROJECT VALUATION
ZONING
ASSESSOR'S TAR /PARCEL M
5,000.00
CE- Comm. Ent
2 0 2 1 0 4- 9 0 8 8
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION
NAME OF PROJECT
(Tenant Name /Homeowner Last Name/
21 Ways Retail Building A
PROJECT DESCRIPTION
Detailed description of work to
Installing new fire alarm system in new commercial building.
Fire Alarm to cover only "Core" of Building until tenant
bulid-out can begin.
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
21 Ways LLC
253 - 951 -9354
MAILING ADDRESS
33255 139th Terrace S.E.
E-MAIL
CITY uburn
sWA WA
98092
NAME
Protection & Communications, Inc.
PHONE
425 - 774 -9099
MAUdNG ADDRESS
19630 40th Ave. W.
E-MAD.
CONTRACTOR
crrx Lynnwood
STATE AE
ZIP
FAX F"'1425- 774 -6317
WA STATE CONTRACTOR'S LICENSE 0
PROTECI165L8
ERPIRATION DATE
05 31 X13
FEDERAL WAY BUSINESS LICENSE B
19 -99- 105961 -00 -BL
NAXE Protection & Communications, Inc.
PIIO425- 774 -9099, Ext. 115
APPLICANT
MA 1968 0
30 40th Ave. W.
l@pro - Comm- online.com
�yle
CITY Lynnwood
STATE A
ZIP 98036
FAX
PROJECT CONTACT
NAME Wells
Lyle
PHONE Ext. 115
(Tile individual to receive and
respond to all correspondence
concerning this application)
MAULING ADDRESS
19630 40th Ave. W.
E -MAIL
lylew @pro- comm- online.com
crrY Lynnwood
gWA
ZIP 98036
"425- 774 -6317
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
Mark Shepherd
206- 510 -1782
PROJECT FINANCING
NAME
OWNER - FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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
it4formation supplied to the city as a part of this application.
SIGNATURE: DATE 11/13/12
PRINT NAME: Lyle Wells
Bulletin #100 — January 1, 2011 Page 1 of 3 k:\Handouts\Permit Application