17-104953 CITY OF '% PERMIT APPLICATION
Federal Way RECEIVED
� s � � OCT 132017
PERMIT NUMBER / _
TARGET DATE crrY Of rCDERAL WAY
cOMMUNMY OEV:ELOPMENT
SITE ADDRESS 31503 Pacific Hwy S, Federal Way, WA, 98003 SUITE/UNIT#
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 8800.00 0 8 2 1 0 4 - 9 1 8 1
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING • FIRE PREVENTION
NAME OF PROJECT 85°C Bakery Cafe
ADD AND RELOCATE(60)PENDENT QR SPRINKLERS TO RESTORE COVERAGE AT REMODELED
PROJECT DESCRIPTION WALLS AND CEILINGS
Detailed description of work to
be included on this permit only
PRIMARY PHONE 714-459-9565
NAME 85°C Bakery Cafe
PROPERTY OWNER
MAILING ADDRESS 31503 Pacific Hwy S E-MAIL
crrY Federal Way STATE ZIP 98003
NAME Columbia Fire PHONE 206-232-8569
MAILING ADDRESS 1 1 1 S Findlay St. E-MAIL
CONTRACTOR peters(acolumbiafire.net
CITY Seattle STATE ZIP 98108 FAX 206-340-6100
WA
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUST:ESS LICENSE #
COLUMFI952MG 12/31/2017 #216019-87-000014-00-BL
NAME Columbia Fire PRIMARY PHONE 206-232-8569
APPLICANT MAILING ADDRESS 1 1 1 S Findlay St. E-MAIL inna@columbialire.net
CITY Seattle STATE ZIP 98108 FAX 206-340-:d00
WA
NAME PRIMARY PHONE 06-232-8569
PROJECT CONTACT
(The individual to receive and MAILING ADDRESS 1 1 1 S Findlay St. E-MAIL inna@colu. ,biafire.net
respond to all correspondence
concerning this application) CITY Seattle STATE ZIP 98108 FAX 206-340- 100
WA
NAME
PROJECT FINANCING D OWNER-FINA. ICED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHC E
(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 the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will cc tply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understar !that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws sgulating
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 ircurred in
the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed again t the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the occur, :y of the
information supplied to city as a part of thi application.
SIGNATURE: DATE /69// -
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Bulletin#100—January 1,2013 Page 1 of 3 k:\Flandouts\F -mit Application