17-104108 CITY OF PERMIT APPLICATION
Federal Way
RECEIVED
PERMIT NUMBER I _ 1 0 4\ \ O g. 'EP°_ AUG 2 4 2017
- -
- - TARGET DATE
CITY OF FEDERAL WAY
SITE ADDRESS COMMUNr-ui- A NENT
1727 S. 316th Street
P45r2
CT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ o 9 2 1 0 4 - 9 3 0 4
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ®FIRE PREVENTION
NAME OF PROJECT Palace Spa T.I.
Add and relocate sprinklers for T.I. walls and
PROJECT DESCRIPTION
Detailed description of work to ceilings. c - r. . • - . . - - - .: - ..•r_uur_Isgr_ut•
be included on this permit only
- - - - - - • - - - . I • a . • -
PROPERTY OWNER NA'Western Palaside Inc PRIMARY PHONE
MAILING ADDRESS E-MAIL
1805 S 316th Street
CITY Federal WaySTATE ZIP
WA 98003
NAME Patriot Fire Protection, Inc. PRONE
253-926-2290
MAILING ADDRESS 2707 70th Ave E EMAIL
CONTRACTOR
CITY STATE ZIP FAX
Tacoma WA 98424 253-922-6150
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PATRIFP099CF 10 05/ 17 19-91-101988-00-BL
NAME PRIMARY PHONE
APPLICANT MAILING ADDRESS E-MAIL
Same as above
CITY STATE I ZIP FAX
NAME Matthew Greene PRIMARY PHONE
PROJECT CONTACT 253-377-2272
MAILING ADDRESS
(The individual to receive and E-MAIL
respond to all correspondence Same as above mattq@a patriotfire.com
concerning this application) CITY STATE ZIP FAX
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 'y as • part o, this application.
SIGNATURE: ,e/��%
DATE 8/23/17
PRINT NAME: Matthew 'Irene
Bulletin#100-January 1,2013 Page 1 of 3 k:\I-Iandouts\Permit Application