17-103711 RECEIVED
41% AUG 0 2 2017 PERMIT APPLICATION
CITY OF °.'
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
Federal CI Y OF FEDERAL WAY 253-835-2607+FAX 253-835-2609+permitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER t _ 1 3 1 August 2017
TARGET DATE g
SITE ADDRESS SUITE/UNIT#
34503 9TH AVE S 208
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 4,339.00 7504510050 _
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING (] FIRE PREVENTION
NAME OF PROJECT CHI ST Francis Cardiac Rehab
Relocating existing sprinklers to accommodate the new walls and ceilings at remodel Tenant Improvement
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
CHI Franciscan (Laurie Kearney) 206.755.8608
PROPERTY OWNER MAILING ADDRESS E-MAIL
PO Box 2197
CITY STATE ZIP
Tacoma WA 98401
NAME PHONE
FIRE SYSTEMS WEST 253-833-1248
MAILING ADDRESS E-MAIL
CONTRACTOR 206 FRONTAGE RD N,SUITE C Carlosl@Firesystemswest.com
CITY STATE ZIP FAX
PACIFIC WA 98047 253-735-0113
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FIRESWI 140B1 12 31 2017 216019-87-000014-00-BL
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT CARLOS LUGO 253-833-1248
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 206 FRONTAGE RD N,SUITE C Carlosl@Firesystemswest.com
concerning this application) CITY STATE ZIP FAX
PACIFIC WA 98047
NAME
PROJECT FINANCING 0 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
ail 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 the city as a part of this application.
SIGNATURE: DATE 8/2/17
PRINT NAME: Carlos Lugo
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application