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CITY 1
BUILDING DIVISION• CpMMUNIT!Nn� 91T9eP9AR!TMEM 33530 First Way South
Ry Federal Way,WA 98003
(253)661-4000
Fax(253)661-4129
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: 37/Y
FPS99 - 1Z0
PARCEL # Commercial ,14 Residential ❑
SITE LOCATION
Tenant/Owner ��r6) Et(p MSivn Phone
CczvhiouS L01
Address/City/State/Zip 3 LIS' S r 3 tI q k� , �t.1 9 c t)O <«
Nature of Work 4 .�. �. _S`Jr;h c Qc r Yl eft,l<< d r Project Valuation:$ % 'I Rr
-R_Xpechsf`dn of jrblutn4 sPx1'ef,.44 C.API/.
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APPLICANT
Name
Address/City/St/Zip
Contact Person Phone Fax
CONTRACTOR 1I
Company Name tx f r 8't h rte, l-'/n�i74ei—`t1'�1it Th
Address/City/St/Zip a-7(1)7 76 J-, E. t -6-‘)#4 9 R 4'2 Zl
Contact Person (J..i At rt.Y✓ Phone 02---/:f7,; Fax 90a
State L&I Contractor Registration# Parte r' c'Po 1 Exp.Date 16`/51 Ob
(Card must be presented)
•
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(ncluding costs,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 of the reliance of the city,including its officers and employees,upon the accuracy of the
mformaeor.seppbed to the city as a part of this application_
Owner/Agent Date // >/F%
FPS.APP
Revsm 5/19/99
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