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�+ G ry.. d BU ay, DIVISION
03
V V (��/ Fed3elsl Wa30 ytWAySouth
98003
REC �' (253)661-4000
1111
Fax(253)661-4129
FIRE PROTECTION1(2 EM APPLICATION
Federal Way Business L .,',g= �3 7/'-/
�4`�Y DF��f
BUILDING Di=d' `,
ro
FPS®2 - /02_ 0q 7`
PARCEL# `�R4 0� Lo DO(3 7
Commercial Cg-'' Residential 0
JUL 3 0 2('°3
SITE LOCATION �iIY OF FEDERAL WAY
Tenant/Owner J r vn P I e),- ��-V I nt�e(� BUILDING DEFI
Phone
Address/City/State/Zip 3 a 60 I S : 3 Q"k _ t=r yr CA-)62-1 Q d
hfr1O okay* -NY- r►. C 1I lfl0 C°
Nature of Wor S Project Valuation:$SaOo
APPLICANT j C{ j
Name 17 �t O f T !� Y � iec-h w
110 Address/City/St/Zip Z�� -V AV-chyle, G%AS4
Contact Person "0 Y �` V C C Phone (ZS-3) ''2/2-/0 Fax (7,53)122-- 2I,5O
CONTRACTOR
Company Name Pal-VA f") P Voltec4(co
Address/City/St/Zip n V �v6 Y t t �CW f v V ZL�
Contact Person L)O nl [)(4 (A Phone 31(121-- i(� Fax (2 )q22' b1
State L&I Contractor Registration# 12 hi puff O' CF- Exp.Date d a JSfoci
(Card must be presented)
PLEASE SUBMIT THREE(3)SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SI7,F.: 24"x 36"
1,:.>ISCLAIMER I certify,under penalty of perjury,that the infomwtion furnished
which �'me is urns and to the Last ofmy knowledge and fudher that I am authorized by the owner of the above premises to perform the work
made P it application is made.t further agree to save harmless the City of Federal Way as to any claim Cmduding ,expanses,and attorneys'fees metered in investigation and defense ofarch claim),which maybe
by any pion.including the undersigned,and 5kd against the City of Federay Way but only whore such claim arises out of the reliance of the city,including its offices and employees,upon the accuracy of the
information supplied to the city as a pad of this application.
ill I Owner/Agent / Y� kilt. Date
FPSApP
REVISE)5119199