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• RECEIVED411
CITY OF I- BUILDING DIVISION
• OCT 0 81999 33530 First Way South
)V FlY Federal Way,WA 98003
CITY OF FEDERAL WAY (253)661-4000
BUILDING DEPT. Fax(253)661-4129
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number;
FPS 9.1F
_ 6)09
PARCEL# 7 Sa �'�� — �D 'S Commercial 0 Residential ❑
SITE LOCATION
Tenant/Owner Dr 9w 42-SS _., ,,. Phone
Address/City/State/Zip 3 f 3 (23 x`h S
Nature of Work !en n'4r rrn 1 Tait o r/'e ,I tl l vi
�J' � ......_ Project Valuation:$ �
APPLICANT # (2 -/
Name r I h nQ �� .� r� Aim I p '3'j L.E /�Address/City/St/Zip 2 1 tJ wzvt"`Y't / 4-✓2- 4<-PM
Contact Person 9 0 7`7" a✓`cd e ✓ 2 �S - , S "Seo
Phons ,j3 P�/ Fax
CONTRACTOR
Company Namee c
Address/City/St/Zip I 172 n 047,41",1 V I /i'P, �✓9O Y
Contact Person 1/17-a(/ Yl P Phone Fax
State L&I Contractor Registration# �� LV.-e) Exp.Date
(Card must be presentee°
PLEASE SUBMIT THREE(3)SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" X 36"
DISCLAIMER:I certify,under penalty of perjury,that the information furnished by me is true and correct to the best of my knowledge and further that I am authorized by the owner of the above premises to perform the work
for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including casts,expenses,and attorneys'fees incurred in investigation and defense of such claim),which may be
made by any person,including the undersigned,and filed against the City of Federay Way but only where such claim arises out'.F 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.
Owner/Agent - , til� T Date /!J —
FPS.Aee
REvrsE 5/19/99