14-101362 `"�dera■
• PERMIT N vi, _ _ i o ( 3 k 2_,_
MF CO ME PL DE EN
Federal Way \.J
COMMUNITY DEVELOPMENT SERVICES APP LI CATION
253-835-2607'FAX 253-835-2609 MAR 2 6 2014
www.cituoffederalway.com �/ ED ERA
�1
SITE ADDRESS Cl 1 I OF FEDERAL WAY SUITE/UNIT#
I,. '2d(C(3 s 00 M14OBIS CDS c-10
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$10,334 7 6 2 2 4 0 _ 0 0 1 0
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING El FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) Famous Foot Wear At the Commons
Add and relocate fire sprinklers for tenant improvement
PROJECT DESCRIPTION -
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Commons Mall, LLC 949-852-0700
MAILING ADDRESS E-MAIL
18100 Von Karman
CITY STATE ZIP
Irvine CA 92612
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
Brett Morrison 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
Brett Morrison 253-826-0099
(The individual to receive and
respond to all correspondence MAILING ADDRESS
concerning this application) 1524-45th St E Suite 102 Brett@FireSprinklerslnc.com
CITY STATE ZIP FAX
Sumner WA 98390 253-826-1033
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME 0 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 cert(fy 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 defer of such claim), which may be made by any person,including the undersigned,and filed against the city,
but only where such cl•jil arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information sup to cit as a part of this application.
SIGNATURE: _ t/' ��1��ZN T- DATE
3/i �t-
PRINT NAME: ' �'1.TT ° (tom
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application