14-106100 -7111,
• RECEIVED
ar.o� NOV 2 5 PERMIT APPLICATION
Federal Way 2014
CITY OF FEDERAL o _ f-y WAY
PERMIT NUMBER / q _ ( Dk, D(( TARGET DATE
SITE ADDRESS SUITE/UNIT 8
34920 ENCHANTED PARKWAY
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N
$ 11, 800 2192600570 -
TYPE OF PERMIT ❑BUILDING ❑PLUMBING ❑MECHANICAL ❑DEMOLITION ❑ ENGINEERING [51 FIRE PREVENTION
NAME OF PROJECT SEATTLE CHILDREN' S HOSPITAL SOUTH SOUND CLINIC
Installation of intelligent Fire Alarm System in
PROJECT DESCRIPTION
Detailed description of work to _existing building.
be included on this permit only
—
NAME PRIMARY PHONE
PROPERTY OWNER Seattle Children' s Hospial
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
Siemens Industrys 425. 507 . 4350
MAILING ADDRESS °'-"•T'
22010 SE 51st St. pbruce.gardner.ext @siemens.cclm
CONTRACTOR
cITY Issaquah LI.Alit Z� 98029 FAX 425 . 507 .4350
C I;T AC I R I;L CENSE 6 EXPIRATION DATE FEDERAL maw NDSUIESS LICENSE$
SIEMEII919PP 12/ 31 /14 20-02-100822-00-BL
NAME PRIMARY 1.1101F
Bruce Gardner 425. 507 . 4353
APPLICANT MAILING ADDRESS 22010 S E 51st St. E-MAIL
bruce.gardner.ext @siemens.c�m
CITY ST E ZIP Fax 425. 507 . 4350
Issaquah WA 98029
NAME PRIMARY PHONE
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS E
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
PROJECT FINANCING MUM ❑ OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 29.27 095)
I certify under penalty of perjury that T 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 taws 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 ' a part of this application.
SIGNATURE: I r��"°mil DATE 11-21-2014
PRINT NAME: Bruce S.. Gardner
JP
Bulletin#100–January 1,2013 Page 1 of 3 k:�Handouts�Pelmit Application