17-104363 RECEIVED
cm,oF.:411. SEP 11 2017 PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER _ J 0 (� 3 — F
_ TARGET DATE
SITE ADDRESS SUITE/UNIT#
29807 20th Ave S, Federal Way WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL it
7517 . 00 3 6 7 4 4 0 - 0 1 9 7
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING EXPIRE PREVENTION
NAME OF PROJECT Suneet Residence
13D Residential Fire Sprinkler System (29 Sprinklers)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Fed Way 20th Ave Homes LLC
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME Emerald Fire PHONE 253-857-2056
MAILING ADDRESS 11021 Cramer Road KPN E-MAIL
CONTRACTOR angiev@emeraldfirellc.com
CITY Gig Harbor STATEWA ZIP FAX
FAX
253-857-2312
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 44
EMERAFL980MR 7 � 19 18
PRIMARY PHONE
NAME Emerald Fire 253-857-2056
APPLICANT MAILING ADDRESS 11021 Cramer Road KPN E-MAIL
angiev(a,emeraldfirellc.com
CITY STATE ZIP FAX
Gig Harbor WA 98329 253-857-2312
PROJECT CONTACT NAME Angie Voelpel /Emerald Fire PRIMARY 857 2056
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 11021 Cramer Road KPN angiev(cr�emeraldfirellc.com
concerning this application) CITY GigHarbor STATE ZIP FAX
WA 98329 253-857-2312
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.
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SIGNATURE: A L L/'(3? (/./l )r DATE 8/29/17
PRINT NAME: Angie Voelpel
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application