17-105118 RECEIVE®
MY Of A, OCT 2 3 2017 PERMIT APPLICATION
Federal WaxiTY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
MUNfiY DEVELOPMENT 253-835-2607+FAX 253-835-2609+permitcentera;cityoffederalway.com
/ 0 5- / / y F 0 c______,,,,_, ,,,__
PERMIT NUMBER _ _ TARGET DATE _ �. f
SITE ADDRESS SUITE/UNIT#
505'S. 336TH ST 320A
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL#
$ 1093 9 2 6 4 8 0 — 0 2 4 0
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL ❑DEMOLITION 0 ENGINEERING leIRE PREVENTION
NAME OF PROJECT EDWARD JONES
ADD A NOTIFICATION DEVICE FOR TENANT IMPROVEMENT.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
RH FOUNTAIN PLAZA ASSOC. LLC
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
SMITH FIRE SYSTEMS (253) 248-2004
MAILING ADDRESS E-MAIL
CONTRACTOR 1106 54TH AVE E SCOTTJ@SMITHFIRE.COM
TACOMA STATE ZIP 98424 FAX (253) 926-0726
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
SMITHFS861 RS 12 i 10 18 198700005500BL
NAME S/A PRIMARY PHONE..S/A
APPLICANT MAILING ADDRESS S/A E-MAIL
S/A
CITY S/A STATE ZIP FAX S/A
NAME SCOTT JERKE PRIMARY PHONE S/A
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS S/A E-MAIL S/A
respond to all correspondence J
concerning this application) CITY
S//� STATE ZIP FAX S/A
NAME a7 /'1 _._.- ._.. _.... _.._..
PROJECT FINANCING ❑ OWNER-FINANCED
When value is$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 of this application. /
SIGNATURE: ._.--e�-- � `� .-__- DATE 10/17/17
PRINT NAME: SCO T JERKE
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application