17-105454 ' RECE►vED: PER
CITY OF MIT APPLICATION
Federal Way NOV 0 9 2017
CITY OF FEDERAL WAY %
"MMUNITY DEV L.OPM
_
PERMIT NUMBER / /
—'P.). / O S---
� FP
(F ((( TARGET DATE r --...'.. 3
SITE ADDRESS SUITE/UNIT#
1426 S 324th St
A108
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
1 5 0 0 5 0 _ 0 0 8 0
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING Eg FIRE PREVENTION
NAME OF PROJECT Domino's
Install two devices for new bathroom remodel
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME .. .. . PRIMARY PHONE ... ..
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME .. .. ...
PHONE
Zeus Fire&Security,LLC 253-445-6561
MAILING ADDRESS E-MAIL
CONTRACTOR PO Box 731247 kris@zeusfire.com
CITY STATE ZIP FAX
Puyallup WA 98375 253-617-0693
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ZEUSFFS861R4 12 24 /18 15 101265 000 00 BL
NAME
...
...
PRIMARY PHONE
Same
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
.. ..
_ __NAME . .. .. ,_ ..
PRIMARY PHONE
PROJECT CONTACT Kristopher Conner 253-445-6561
MAILING ADDRESS EMAIL
(The individual to receive and
PO Box 731247 kris@zeusfire.com to all correspondence fire.com
concerning this application) CITY STATE ZIP FAX
Puyallup WA 98375 253-617-0693
NAME - .. .. ...
PROJECT FINANCING 0 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP
(RCW 19.27.095) PHONE
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 ut of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ci part of this application.
SIGNATURE: DATE 11/9/2017
PRINT NAME: Kristopher Conner
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application