13-101776 - t REINED
•
CITY OF•:� APR 22 2013 PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY �b4�g
CDS
PERMIT NUMBER / 3 _ / 0 1 7 t _
7 TARGET DATE
SITE ADDRESS SUITE/UNIT#
2010 E 344th St. A8
PROJECT VALUATION ZONING ASSESSnR'C TAY/DAq(`c.T..A
$ 250.00 a CP / 0 v ? 0
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ® FIRE PREVENTION
NAME OF PROJECT Garagetown USA Unit A8
Provide for tenant improvement.
PROJECT DESCRIPTION
Detailed description of work to >f;H 671Z.‘,12-€_
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Garagetown USA 425-637-8555
MAILING ADDRESS E-MAIL
1611 116th Ave NE, Suite 119
CITY STATE ZIP
Bellevue WA 98004
NAME PHONE
Kirby Electric Inc. 253-859-2000
MAILING ADDRESS E-MAIL
CONTRACTOR 4826 B St. NW, Suite 101 paulAkirbyelectric.com
CITY STATE ZIP FAX
Auburn WA 98001 253-859-2363
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
KIRBYEI077BN 01 13 15 19-90-101897-00-BL
NAME PRIMARY PHONE
Paul Hoskins 253-859-2000
APPLICANT MAILING ADDRESS E-MAIL
4826 B St. NW, Suite 101 pauk kirbyelectric.com
CITY STATE ZIP FAX
Auburn WA 98001 253-859-2363
NAME PRIMARY PHONE
PROJECT CONTACT Same as applicant
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
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 city as a part of this application. p
SIGNATURE: t DATE t/v-01/
PRINT NAME: V-kA-1
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application