14-102122 car OF E- ... PERMIT.PPLICATION
Federal Way
I , I
PERMIT NUMBER 1 1 1 O z. t z z- _
TARGET DATE
SITE ADDRESS SUITE/UNIT#
33530 Pt. u& 5. FEDERAL WAY, 98003 1 O-
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 795.00 1 5 9 4 4 0 - 0 0 0 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING IY1 FIRE PREVENTION
NAME OF PROJECT ACROBAT FINANCIAL SERVICES, LCC
REPLACE EXISTING S.T.U. FIRE ALARM DIALER WITH A.E.S. RADIO TRANSMITTER
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER ACROBAT FINANCIAL SERVICES (253)332-6763
MAILING ADDRESS E-MAIL
31620 23RD AVE S
CITY STATE ZIP
FEDERAL WAY WA 98003
NAME PHONE
ALARM CENTER INC. (800) 354-1555
MAILING ADDRESS E-MAIL
CONTRACTOR PO BOX 3407 sanderson(&,alarmcenterinc.com
CITY STATE ZIP FAX
LACEY WA 98509
WA STATE CONTRACTOR'S LICENSE 41 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ALARMCI055CW 02/ 15 / 16 20-00-101-452-00-BL
NAME PRIMARY PHONE
SAME AS ABOVE
APPLICANT MAILING ADDRESS E-MAIL
SAME AS ABQVE
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT SCOTT ANDERSON (800) 354-1555
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence PO BOX 3407 sanderson@alarmcenterinc.com
concerning this application) CITY STATE ZIP FAX
LACEY WA 98509
NAME
PROJECT FINANCING ❑ OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 accu of the
information supplied to the city as a part of this application. IKv
SIGNATURE: j�" "�`��-- DATE MAY 0 8 2014
PRINT NAME: SCOTT ANDERSON
CITY OF FEDFRAI WAY
CDS
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application