17-103464 RECEIVED
41/4 JUL 19 7017 PERMIT APPLICATION
PTes"dF
eral Way CITY FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
COMMUNIS'D /ELOPNIEM 253-835-2607+FAX 253-835-2609+permitcenter(r/cityoffederalway.com
PERMIT NUMBER / 7 _ (e) 3 V TARGET DATE
SITE ADDRESS SUITE/UNIT#
35419 1st Avenue S
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 2 1 0 4 - 9 0 2 4
22,815.00 3 0
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING i FIRE PREVENTION
NAME OF PROJECT Cottages West-Village Green Retirement Campus
Provide overhead sprinkler protection in (4) units.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
Village Green Federal Way 253-838-3700
PROPERTY OWNER MAILING ADDRESS E-MAIL
35419 1st Ave S
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Cascade Fire&Security/Cascade Alarm, LLC 206-767-5800
MAILING ADDRESS E-MAIL
CONTRACTOR PO Box 7459 rcraine@cascadealarm.com
CITY STATE ZIP FAX
Kent WA 98042 253-630-4851
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
CASCAAL962RW A /(# (2 12.- 19-82-000022-00-BL
NAME PRIMARY PHONE
Same as Contractor
APPLICANT MAILING ADDRESS E-MAIL //�.J�
CITY STATE ZIP FL (.-
NAME PRIMARY PHONE
PROJECT CONTACT Roxanne Craine 206-767-5800
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence PO Box 7459 rcraine@cascadealarm.com
concerning this application) CITY STATE ZIP FAX
Kent WA 98042 253-630-4851
NAME
PROJECT FINANCING ® OWNER-FINANCED
When value is$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 accuracy of the
information supplied to e city art of this application.
SIGNATURE: ( ' DATE --1/10/17
PRINT NAME: I�t�Fi 15:A d( - or-FILF,
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application