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N 03 41.
CITY OF BUILDING DIVISION
33530 First Way South
```` FRY
���� Federal Way,WA 98003
\/\/ y SEP 0 2 (253)661-4000
Fax(253 661-4129
(ii1Y L. l�TVVA
BUILDING DEPT. PERMIT# [
FIRE ALARM PERMIT APPLICATION
Job Address: / ,642-&114,-/a14.-" 3APJ /EcC���� / Rb
j (S�) (City) (State) (Zip) (Suite f0
✓
Owner: 6-T/L Ci /QST 'pant Name:
Contractor:i1 /u�L, dr • 4. /J Sfax Parcel#
Address: 393 O /45-7- J`�f� �C�/1 �� fr (�f .
Phone: /�/ Contractor License#:` J /11(4C/0 709' Expiration Date: / // 8
/�' Ald must be presented)
Owner's Address: 47`, Vg / ' 842 c�-&r7—
l/ Phone:
Contact Person:? '%Q ? c! /v //_S /"l"L(Sf Phone: — 3 cl
PLEASE SUBMIT THREE SETS OF FIRE ALARM WIRING DIAGRAMS,DEVICE LOCATION PLANS,
AND CUT SHEETS WITH THIS APPLICATION.
INDICATE NUMBER OF ZONES ON PANEL,INCLUDING SPRINKLER ZONES,IF APPLICABLE: �e
MAXIMUM PLAN SIZE=24"x 36"
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge and further that I am
authorized by the owner of the above premises to perform the work for which permit application is made. I further agree to save harmless
the city of federal way as to any claim(including costs,expenses,and attorneys'fees incurred in investigation and defense of such claim),
which may be made by any person,including the undersigned,and filed against the city of federal way,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.
Owner/Agent:_ ( � Date. 1 e
Office Use Only(Please do not write below this line)
Remarks:
City of Federal Way Electrical
Permit shall be posted at all Permit Fee(Includes First Zone) $30.00
fire alarm installations. Additional Zones @$10.00 ea.
Processing fee $20.00
❑ Received Total Fees $
Route to: Fire Department
Approved by: Date:
FTREAIAMAPP
REVISED 8/26/97