12-104333 •
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� �iY PERMIT RECE SF MF CO ME PL DE EN 0
COMMUNITYDE.ELOPMFAX 3NT ERVICES APPLICATION SEP 212012
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CITY OF FEDCDS dERAL WAY n
SITE ADDRESS SUITE/UNIT#
32073 PACIFIC HWY. S. BLDG. C
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1,450.00 1 5 0 0 5 0 - 0 1 1 0
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) ROSS PLAZA - BUILDING C
CONNECT NEW DRY FIRE SPRINKLER SYSTEM INTO EXISTING
PROJECT DESCRIPTION
Detailed description of work to SPRINKLER MONITORING SYSTEM.
be included on this permit only
NAME ---- -.-.® ........_-.PRIMARY PHONE_.... __. ..._..
PROPERTY OWNER HARSCH INVESTMENT PROPERTIES LLC (425)649-8000
MAILING ADDRESS E-MAIL
13228 NE 20th ST.-SUITE 300 stever@harschcom
CITY STATE ZIP
BELLEVUE WA 98005 (425)649-8001
NAME '.. -_ --- _._._.
PHONE�.. —, a -.
ALARM CENTER INC. (360)786-0404
MAILING ADDRESS E-MAIL
CONTRACTOR PO BOX 3363 mmoore@alarmcenterinc.com
CITY STATE ZIP FAX
LACEY WA . 98509-3363 (360)438-4244
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ALARMCI055CW 2 16 13 20-00-101452-00-BL
NAME _......... —_ . ........-... .._. _
PHONE
ALARM CENTER INC. (360)786-0404
APPLICANT MAILING ADDRESS E-MAIL
PO BOX 3363 mmoore@alarmcenterinc.com
CITY STATE ZIP FAX
_ LA_CEY WA 98509-3363 (360)438-4244
PROJECT CONTACT NAME
PHONE _.._ _. _
MIKE MOORE (360)786-0404
(The individual to receive and ( )
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) PO BOX 3363 mmoore@alarmcenterinc.com
CITY STATE ZIP FAX
LACEY WA 98509-3363 (360)438-4244
ALTERNATE CONTACT NAME: PHONE E-MAIL
JAMIE FOSSETT (360)786-0404 jfossett@alarmcenterinc.com
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 certify 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 defense of such claim),which may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied t t ci as , • of this application.
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SIGNATURE: J DATE ( ~
PRINT NAME: MIKE MOORE
Bulletin#100—January 1.2011 Page 1 of 3 k:\Handouts\Permit Application