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CITY OF �� • •
BUILDING DIVISION
```` F�'"� li33530 First Way South
>V FIN, Way,WA 98003
DEC A 1999 BUILDING
661-4000
Fax(253)661-4129
CITY Chi-,:,. ;.
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number:
F P SA- _6_(.2,__9_
PARCEL # 522/17Y.-- D C I 1 Commercial"( Residential 0
SITE LOCATION
Tenant/Owner .-77-jP4 Ldf y Phone
Address/City/State/Zip 7c k/-4` /6 c(.(J (-eickti2 1 A)'J' Yiao 3
7
,,-- , , , ,
ll LLam`` - �i�f / !�
Nature of Work d L res- i' (.f/ r`+�" STY Project Valuation: $ /OMC
P
5>.-5.fet/t. ---'--,
APPLICANT
Name /fe e A2'- i-J/9A--
Address/City/St/Zip 7'- '2,9 (1 c4, /00 0 -tel 2 't P , A25( l`vV 1�✓6t- ) 2/
Contact Person 6://e-G-t- / Ci4 " J Phone (7.573
)gc6'15116Y-44d(Fax(Z.'- . 1 4ri . '
CONTRACTOR `
Company Name 6I f4.- FAy, 1 'v},mac i-i..- --
Address/City/St/Zip 7 yQ (7 54- Viit)r Co, f.--e k 7`-C4t)<vL Wk V/
J�
Contact Person C°Alf)--- 7- ( li
llekf PhoneC5-7I 1 gab /) 1c f/o/FaxEt5 3) 1- 70'71-
State
(},j 1-State L&I Contractor Registration# (AA(.-- I Q I c1// FP /„.2(.:-/-/ Exp.Date 1-3'''062
(Card must be presented)
PLEASE SUBMIT THREE(3)SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" x 36"
DISCLAIMER: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 undersignfil against tttpe{fj/g f Federay 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 pap_crithis applic 'on. // r/
i
Owner/Agent CA ( Date
FPS.Arr
REVISED5/19/99 ///