14-100310 h. 1 1Lit .... 1
CITY OF A REltkivED PERMIT PPLICATION
Federal Way
JAN 2 12014
/ CITY OF FE E
PERMIT NUMBER _ ��
C� 1Y - Fe ---------_______)
V �vJTARGET DATE --,
SITE ADDRESS SUITE/UNIT#
33405 8th Ave S., Federal Way, WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 2000. 9 2 6 5 0 0 _ 0 0 6 cli
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION 0 ENGINEERING In FIRE PREVENTION
NAME OF PROJECT Evergreen Corporate Center
adding 5 devices to existing FACP.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME --. PRIMARY PHONE
PROPERTY OWNER Evergreen Corporate Plaza ,
MAILING ADDRESS E-MAIL
33405 8th Ave S.
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Guardian Security Systems
MAILING ADDRESS E-MAIL
CONTRACTOR 1743 First Ave S.
CITY STATE ZIP FAX
Seattle WA 98134
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 8
GUARDSS233K5 09/ 30 / 14
NAME PRIMARY PHONE
Guardian Security Systems 206.349.5889
APPLICANT MAILING ADDRESS E-MAIL
1743 First Ave S. kveliz@guardiansecurity.com
CITY STATE ZIP FAX
Seattle WA 98134 206.628.4990
NAME PRIMARY PHONE
PROJECT CONTACT Sales Rep: Dee Sagrelius 206.349.5647
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 1743 First Ave South dsagrelius@guardiansecurity.com
concerning this application) CITY STATE ZIP FAX
Seattle WA 98134 206.658.4990
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 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 a plication.
r
,
X/ '1.04
SIGNATURE: � -" �/ ca.() DATE
PRINT NAME: Karina Veliz
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application