15-100611 RE1PVED I •
CITY OF FEB 0 9 2015 PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY
`CDS 0
PERMIT NUMBER I 5 _ / 0 / / - PP
s TARGET DATE
SITE ADDRESS SUITE/UNIT#
1860 South 336th Street Federal Way, WA 9800
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 8,000.00 7 9 7 8 2 0 - 0 1 0 0
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL ❑DEMOLITION 0 ENGINEERING EXPIRE PREVENTION
NAME OF PROJECT Russian Ukrainian Church
Install an Addressable Fire Alarm System, as per drawings.
PROJECT DESCRIPTION
Detailed description of work to 1 FACP, 1 SMOKE DETECTOR, 8 STROBES, 5 HORN STROBES, 1 PULL STATION
be included on this permit only AND 4 ADDRESSABLE INPUT MODULES.
NAME PRIMARY PHONE
PROPERTY OWNER Western Wash Corp of 7th Day
MAILING ADDRESS _.;r E-MAIL
1860 S 336th Street
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Meridian Security & Electric, Inc 253-638-1792
MAILING ADDRESS E-MAIL
• -P O0 BOX`7171 'scoff@meridiansecurity.biz
CONTRACTOR
-CITY STATE ZIP FAX
Kent WA 98042 253-638-0396
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
Meridse022d5 03/ 25 12015 20-06-100155-00BL
NAME PRIMARY PHONE
Meridian Security & Electric. Inc 253-638-1792
APPLICANT MAILING ADDRESS E-MAIL
P 0 BOX 7171 scott@meridiansecurity.biz
CITY STATE ZIP FAX
Kent WA 98042 253-638-0396
NAME PRIMARY PHONE
PROJECT CONTACT Scott Harris 253-638-1792
(The individual to receive and MAI ING ADDRESS -
respond to all correspondence P O BO7171 E- MAILscott@meridiansecurity.biz
concerning this application) CITY Kent ST.q'CE ZI§8042 LJ3-638-0396
NAME
PROJECT FINANCING 0 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RC W 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 part of this application.
•
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SIGNATURE: 1J as- DATE 02/06/2015
PRINT NAME: Scott Harris
Bulletin#100—January 1,2013 Page 1 of 3 k:AHandouts\Permit Application