15-100545 ,,, in
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OF
PERMIT APPLICATION
Federal Way FEB 0 4 2015
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PERMIT NUMBER //1 — ) 0 11:1 --' V FP TARGET DATE
SITE ADDRESS 4'e20D SUITE UNIT#
33405 8TH AVE S,4016513,FEDERAL WAY,WA 98003 >—D
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 3,800 9 2 6 5 0 0 - 0 0 6 0
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ENGINEERING leIRE PREVENTION
NAME OF PROJECT HOMESTREET BANK CALL CENTER
THE SCOPE OF THIS PROJECT IS TO ADD NOTIFICATION DEVICES FOR T.I.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER EVERGREEN CORP PLAZA
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
SMITH FIRE SYSTEMS INC. 253-248-2004
MAILING ADDRESS E-MAIL
CONTRACTOR 1106 54TH AVE E SJERKE@SMITHFIRE.COM
CITY STATE ZIP FAX
TACOMA WA 98424 253-926-0726
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FED Rei.Way RUSINESS LICENSE I
SMITHFS861RS 12 / 10 / 16 11,7- 0 COC 5S
NAME PRIMARY PHONE
SMITH FIRE SYSTEMS INC. 253-248-2004
APPLICANT MAILING ADDRESS E-MAIL
1106 54TH AVE E SJERKE@SMITHFIRE.COM
CITY STATE ZIP FAX
TACOMA WA 98424 253-926-0726
NAME PRIMARY PHONE
PROJECT CONTACT SCOTT JERKE 253-248-2004
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 1106 54TH AVE E SJERKE
concerning this application) CITY STATE ZIP FAX
TACOMA WA 98424 253-926-0726
NAME
PROJECT FINANCING 0 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 arty claim(including costs, expenses,and attorneys'fees incurred in
the investigation and defense of such clai ich may be made by any person,including the undersigned,and flied against the city,
but only where such claim arises out = reliance of the city including its officers and employees, upon the accuracy of the
information supplied to the city as a ,, his application.
SIGNATURE: DATE 2/4/15
PRINT NAME: SCOTT JERKE
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application