14-103271 • 44 - 1 (2_ 3_ 2_ ,b
CRY OF A PERMIT SF MF CO ME PL DE EN
Federal Way REC .71
COMMUNITY DEVELOPMENT SERVICES
X1LrCATI ON
253-835-2607•FAX 253-835-2609
www.citgo((ederaiwa4.com (1 II �- 3 2014
SITE ADDRESS CITY OF I-ED SUITE/UNIT#
505 S. 5 5 336th as �c�}��or
PROJECT VALUATION ZONING ASSESSORS TAX/PARCEL#
$ 800.00 9264800270 - _ _
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
0 DEMOLITION 0 ENGINEERING X FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/HomeownerLast Name) 3rd floor corridor
PROJECT DESCRIPTION
Detailed description of work to add or relocate existing sprinklers to the new layout.
be included on this permit only
PROPERTY OWNER NAME FSP FEDERAL WAY CORP PRIMARY PHONE
MAILING ADDRESS E-MAIL
CITY STATE ZIP
'AME Evergreen Fire Protection, Inc. PHONE 253-252-7942
MAILING ADDRESS PO Box 998 E-MAILrgreenfirepro@msn.com
CONTRACTOR
TE ZIP
CITY Puyallup Wa 98371 FAX
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
Evergfp967lz 6 i 8 /2015 20-05-106411-OOBL
'AME same as above
oNE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
—
PROJECT CONTACT NAME PHONE
(The individual to receive and Mike Hutchinson 253-381-4456
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) Evergreenfirepro@msn.com
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
CI OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 relian• • the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a part of . , plication.
SIGNATURE: \ P\I • N DATE 7/1/2014
PRINT NAME: Mike Hutchinson
Bulletin#100—January 1,2011 Page 1 of 3 kAHandouts\Pennit Application