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CITY OF ARECEIVtilERMIT SF MF CO ME PL DE EN FP
Federal Way
COMMUNITY DEVELOPMENT SERVICE EI,J C PLICATION
253-835-2607•FAX 253-835-2609
ww w.cit90 f(ederatwa 4.corn
CITY OF FEDERAL RAL WAY
SITE ADDRESS C D S SUITE/UNIT#
34910 ENCHANTED PKWY S. Federal Way, WA BLDG Y
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
4,434.00 2 1 9 2 6 0 - 0 5 7 0
TYPE OF PERMIT El BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING (Xl FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) WEST CAMPUS SQUARE-BLDG Y
REPLACE FIRE ALARM CONROL PANEL
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER WEST CAMPUS SQUARE SHOPPING CENTER 425-455-1950
MAILING ADDRESS E-MAIL
2010 156TH Ave NE SUITE 100
CITY
Bellevue STATE ZIP
ellevue
WA 98007
NAME Protection & Communication, Inc. PHONE (425)774-9099
MAILING ADDRESS 19630 40th Ave W E-MAIL
CONTRACTOR
O1 Lynnwood SNAA ZIP 98036 FAX (425)774-6317
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PROTECI165L8 05 31 /2013 19-99-105961-00-BL
NAME Protection & Communication, Inc. PHONE (425)774-9099
APPLICANT MAILING ADDRESS
19630 40th Ave W
CITY Lynnwood STATE ZIP FAX
WA 98036 (425)774-6317
PROJECT CONTACT NAME PHONE (4 2 5)508-7722
(The individual to receive and CHERYL RICHARDS
respond to all correspondence MAILING ADDRESS 19630 40th Ave W E-MAIL
concerning this application)
cherylr @pro-comm-online.com
CITY STATE ZIP FAX (425)774-6317
Lynnwood WA 98036
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
El 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 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 of this application.
SIGNATURE: c .:E DATE e2:2 3-ha.,
PRINT NAME: CHERYL RICHARDS
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application