15-106089 •ECEIv ® PERMIIOAPPLICATION
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Federal Way -7_1' 0 2 2015
/� CITY OF FEDERAL WAY
/
PERMIT NUMBER 5 - /0 p u sg ?
- �
U TARGET DATE
SITE ADDRESS SUITE/UNIT#
1316 S 328 th St
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 217,468.00 1 7 2 1 0 4 _ 9 0 0 4
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING g(FIRE PREVENTION
NAME OF PROJECT CELEBRATION SR. LIVING APARTMENTS WEST TOWER
INSTALL A NEW WET & DRY AUTOMATIC SPRINKLER SYSTEM
PROJECT DESCRIPTION
Detailed description of work to WITHIN THE NEW 6 STORY BUILDING
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER CELEBRATION SENIOR LIVING
MAILING ADDRESS E-MAIL
201 27 TH AVE. S E
CITY STATE ZIP
PUYALLUP WA 98374
NAME PHONE
SUREFIRE SPRINKLER CORP. 206-793-7688
MAILING ADDRESS E-MAIL
CONTRACTOR P 0 BOX 719 phil@surefiresprinklers.com
CITY STATE ZIP 88051 FAX
RAVENSDALE WA
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SUREFSC856DD 03 / Oa 17
NAME PRIMARY PHONE
SAME AS CONTRACTOR
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT PHIL FRANCE _2Q6-793-7688
(The individual to receive and MAILING DeEg0X 719 E-MAIL
respond to all correspondence F' phil(a?_surefiresprinkler.carr
concerning this application) CITY STATE ZIP FAX
RAVENSDALE WA 98051
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 apart of this application.
SIGNATURE: /:IIII)
DATE 11/06/15
PRINT NAME: Phil France
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Pemit Application