17-100131 41141L ravED
PERMIT IPPLICATION
tan OFFederal VVay
JAN 1 0 2017 PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
/ 253-835-2607+FAX 253-835-2609+permitcentelracityoffederahvav.com
CITY OF FEDVIIAL wAt
PERMIT NUMBER / _ / O O / 3 / _ pp
TARGET DATE
SITE ADDRESS SUITE/UNIT M
33405 8TH AVE S 275
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL N
$ 3644 9 2 6 5 0 0 _ 0 0 6 0
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION 0 ENGINEERINGRE PREVENTION
NAME OF PROJECT HSB C HOME
ADD NOTIFICATION DEVICES FOR TENANT IMPROVEMENT.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
EVERGREEN CORP PLAZA
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
SMITH FIRE SYSTEMS (253) 248-2004
MAILING ADDRESS E-MAIL
CONTRACTOR 1106 54TH AVE E SCOTTJ@SMITHFIRE.COM
CITY STATE ZIP FAX
TACOMA WA 98424 (253) 926-0726
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE A
SMITHFS861RS 12/ 10 18 198700005500BL
NAME S/A PRIMARY PHONE S/A
APPLICANT MAILING ADDRESS S/A E-MAIL S/A
CITY S/A STATE ZIP FAX
S/A
PROJECT CONTACT NAME SCOTT JERKE
PRIMARY PHONE S/A
(The individual to receive and MAILING ADDRESS S/A E-MAIL S/A
respond to all correspondence J a7/1
concerning this application) CITY !1
S/A STATE ZIP FAX S/A
NAME �7
PROJECT FINANCING 0 OWNER-FINANCED
When value is$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 t application.
SIGNATURE: „.. - "" DATE 1/9/17
PRINT NAME: SCOTT JERKE
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VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(cas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks( TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ 3644
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FI SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home) -_
COVERED ENTRY _-
ttl I)
GARAGE ❑ CARPORT ❑ __
Area Totals EXISTING PROPOSED TOTAL
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
in
AREA DESCRIPTION Area Occupancy Group(s) ' ' # of Additional Information
S.uare Feet Stories
. i
ADDITION ■_
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION IPIPI Occupancy Group(s) Stories Additional Information
s
ffi
TENANT AREA ONLY -y■y
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