14-103774 •
�,rroF JUL 8 2014 PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY
PERMIT NUMBER t 4 _ C Lf _ t� ( it
- - (� TARGET DATE
SITE ADDRESS SUITE/UNIT#
( Lso ROD Commons
P T VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 58444 7622400010 _
—
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING E l FIRE PREVENTION
NAME OF PROJECT Dicks Sporting Goods DSG
Install Fire Alarm System Panel,smoke detectors, horn strobes,tamper switches,pull station,annunciator,
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only Site Contact:Sterling Electric Aaron Graves(425)774-1903
NAME PRIMARY PHONE
PROPERTY OWNER TC @ FW- Mall Stores (800)453-2247 xt 2841
MAILING ADDRESS E-MAIL
2001 S 320TH ST
CITY STATE ZIP 98003
FEDERAL WAY WA V
NAME PHONE
TYCO IS LLC 206-774-9499
MAILING ADDRESS E-MAIL
CONTRACTOR 11824 North Creek Pkwy N#105
CITY STATE ZIP FAX
Bothell WA 98011
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
TYCOIIS88600 09 21 ,2014
NAME PRIMARY PHONE
SAME AS CONTRACTOR
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT JENNIFER COVELLO/NORTHWEST PERMIT 2067749499
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 1345 GULF RD JENNIFER @NWPERMIT.COM
concerning this application) CITY STATE ZIP FAX
PT ROBERTS WA 98281 888-400-0383
NAME
PROJECT FINANCING ❑ 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
information supplied to the city as a part of this application.
SIGNATURE: Jennifer Covello DATE 07/28/2014
PRINT NAME: Jennifer Covello
Bulletin#100–January 1,2013 Page 1 of 3 k:\Handouts\Permit Application