09-100595 �,� 0 g - / d O s--q,5---
Federal Way PEI IVI rf
I. �DEVELOPMENT�81 2ufs SF MF CO ME EL PL DE EN
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FF.F�IL EAY.WA 99718 p�'�y [�J/�� A . m ! !
,, �; i.c FEDERA "A
Theme is requireCroogrination-an incomplete application will not be accepted. Please print legglaii(fig ink)or type.
• PROPERTY- INFOR`,L',TIO.`
sr=ADDRESS- 3541c/ 1ST Pkv SI FEDERAL WAY SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 3 0 a / (0 i/ - c? o a y LOT S (sfl
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) VI L LA Ca E- GREEN Ren R E PA EN-r CENTER
■ PRO_TEL I IRFORMAJIO•,
TYPE OF PEEMPP 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 EMUIEHRING Ja FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of Mork wed on this permit omni
REPLACEMENT OF NON UL3ao CAMPLIAtJ-r KvrCi-(En1 FIRE SuPPRESSNoN
SYSTErn w ‘Thi H 14,P I^k75- AmeREx tit_ 300 SYS1-Ei'n
PROJECT NAME(Name of Ekisiness or Owner Last Name) V I LLA G E G R E.e N
II PEOPLE I.'FOR;L=:TIOPROPEIM 3
OWNER NAME V ILL(�GE GREL�I PRIMARY PHONE
( as3) 9a7 -3700
MAILING ADDRESS CITY.SENTE.71P E-MAIL ADDRESS
35419 /st- PcI S FEDERAL WAY,wA 98003
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
ACCESS FIRE PRorECTicn) SERocESD c C 4RISto9NER CFIERNOFF ('/ s) 9t3-.24.418
MAILENG ADDRESS CITY.STATE,ZIP CELL PHONE
h P o BoX 7573 COV I NGTON,WA 980�/a1. (0206) 3&0- GLPF-1
V(.66/ CITY OF FEDERAL WAY BUSINESS LICENSE E NUMBER EXPIRATION DATE FAX NUMBER
o -104'7 (07 - c c> - (3L ( ) -
carraAcro '$REGISTAMON Tam BEPmATiOW DATE E-MAIL ADDRESS
AccEsc-P 944I z-F 4 - (p-aoi o admin€accessc;reprofection.corn
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Acc.ESS FIRE.PncrecTtoiJ SE2v►cEs,tki c cNaisroPi+Ee_cl Iocref ( yas) 4/(3 -a6:418
MAILING ADDRESS CITY,STATE.ZIP CEL PHONE
Po 60x 7573 Cav'NG-con,w(} 9gotta (Joe ) 380 - (04%2
RELATIONSHIP TO PROJECT FAX NUMBER
o Architect 0 Tenant o Agent 0 Other (425) y 13 -.2.(o449
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT SI-IAt4NOt.IGAit_ CI-VERA(:).FF ( `/ U13 - atoq.8 Adm;ne-e..ccesAte jrokct'Ion
LENDER NAME N/n 19.27.095;
Lender Wes:nation is required if pm}ect value exceeds$5,000
MAILING ADDRESS CITY,sum.ZIP PHONE
( ) -
• DETAILED ELILDING INFORMATION
EXISTING USE PROPOSED USE
ExierriNG /APPRAISED VALUE$ VALUE OF PROPOSED WORK t !tea 4100.06
SPRINELERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER o LASEHAVEN o HIGHLINE 0 TACOMA o PRIVATE(WELL)
Sew=SERVICE PROVIDER o LAKEHAVEN 0 HtGHL UIE o PRIVATE(SEPTIC)
• PROJECT FLOOR AREAS
AREA DATION EXISTING PROPOSED TOTAL
S8.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDFPIONAL FLOORS(DESCRIBE)
DECK(D COVERED OR ❑UNCOVERED?)
GARAGE D CARPORTMUM U
NUMBER OF FLOORS maroons corer, rvur.EMI=er rtaesrseaes®ar TOTAL Sr
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
■ FIXTURES
Indicate number 4-each type offbdure to be installed or relocated as part of this project Do not Include edstIngflrtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPgJCATYON)
AIR BANDUNG UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOOASrOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REPRIG_SYSTEMS
PLUMBING
BATHTUBS lar'n btst oneer cabal LAVS inanue®Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(rote)
EIECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I under penalty qf perjury that I ant the property owner or authorised agent of the property owner.I
my
knowledge,the permittoed in support of this application is true and tom.Ic that to the best ofcity that I will comply with all applicable
City of Federal wag regulations pertaining to the marls authorised by the issuance of a permit.I understand that the issuance of this permit
does not remove the owner's responsi'fkyff r compliance with local,state,or federal lams regulating construction or environmental Lams.
If rther agree to hold harmless the City ofFederal Way ae to any claim Badu ng casts,ate,and attorneys'fees incurred in the
bwestigation and drfeAse of such ), which may be made by any person, int the undersigned, and filed agcdnst the city,but only
where such claim arises out of the reliance of the cityincluding its officers arid esepiogees,noon the accuracy of the information supplied to
the city a a part of this application.
SIGNATURE: C'471DATE .2/37
aAgent
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVIDIENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o IN)
NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO
PLAITED LOT? o YES o NO DMIO PST REQUIRED? o YES o NO