17-102141 RECEIVED
caro MAY09 2017 PERMIT APPLICATION
Federal Way
CITY OF FEDERAL WAY
COMMUPif '�DEVELOPMENT
PERMIT NUMBER /f 7 /_ O �,! / / _ r
11 !Gt 7------N.,„..)
TARGET DATE
SITE ADDRESS SUITE/UNIT#
34029 Hoyt RD SW, FEDERAL WAY,WA. 98023
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1040..2 30 8 9 0 0 _ 0 3 8 5
5
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING Ni FIRE PREVENTION
NAME OF PROJECT NORTH SHORE PLAZA
REPLACE EXISTING DEFECTIVE REMOTE ANNUNCIATOR WITH A NEW RA-1000
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER TIERRA GROUP INC. (425)453-7977
MAILING ADDRESS E-MAIL
10210 NE 8TH ST#208
CITY STATE
WA 98004
NAME PHONE
ALARM CENTER INC. (800)354-1555
MAILING ADDRESS E-MAIL
CONTRACTOR PO BOX 3407 kara@alarmcenterinc.com
CITY STATE ZIP FAX
LACEY WA 98509
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ALARMCI055CW 02 15 19 20-00-101-452-00-BL
NAME PRIMARY PHONE
SAME AS ABOVE
APPLICANT MAILING ADDRESS E-MAIL
SAME AS ABOVE
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT KARA MORROW (360)481-4969
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence PO BOX 3407 kara@alarmcenterinc.com
concerning this application) CITY STATE ZIP FAX
LACEY WA 98509
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 he city as mart of this application.
c---...--•
J JCA /
SIGNATURE Oj.NC-- Vj•._ DATE
PRINT NAME: KA MORROW «I
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application