14-106319 "�� • PERMIT
F der aI Way
MF CO ME PL DE EN FP
COMMUNITY FPT SERVICES APPLICATION AX 25
RECEIVED
www.cituoffederalway.com _C 1 1 2014
SITE ADDRESS C# tIIFRAL WAY
34920 ENCHANTED PARKWAY CDS
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$78.935.00 2 1 9 2 6 0 _ 0 5 7
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) SEATTLE CHILDRENS HOSPITAL- FEDERAL WAY
ADD NEW WET SPRINKLER SYSTEM TO EXISTING UNSPRINKLERED BUILDING
PROJECT DESCRIPTION THAT IS CHANGING TENANTS
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER SEATTLE CHILDRENS HOSPITAL
MAILING ADDRESS E-MAIL
34920 ENCHANTED PARKWAY S
CITY STATE ZIP
FEDERAL WAY WA
NAME PHONE
Fire Sprinklers Incorporated 253-826-0099
MAILING ADDRESS E-MAIL
CONTRACTOR 1524-45th St E Suite 102
CITY STATE ZIP FAX
Sumner WA 98390 253-826-1033
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FIRESI*988RJ 12 X11 X14 20-05-100633-00-BL
NAME PHONE
Fire Sprinklers Incorporated 253-826-0099
APPLICANT MAILING ADDRESS E-MAIL
1524-45th St E Suite 102
CITY STATE ZIP FAX
Sumner WA 98390 253-826-1033
PROJECT CONTACT NAME PHONE
(The individual to receive and
MIKE MOFFETT
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) 1524-45th St E Suite 102 mike @firesprinklersinc.com
CITY STATE ZIP FAX
Sumner WA 98390 253-826-1033
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
Required value of$5,000 or more
El OWNER-FINANCED
(RCW 19.27.0951 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 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
information supplied to the city as a part this application.
SIGNATURE: 6 DATE 12. ' / O ' 14-
PRINT NAME: 44/1e-E 714 t.27=6 T
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application