03-104468 • laece`
vevi •
CITY OF BUILDING DIVISION
E� 33530 First Way South
Ay SCP 003 Federal Way,WA 98003
(253)661-4000
41)
OF FEDERA`W Fax(253)661-4129
Cl��31LD1NG DEP
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: �7/y
F P S• ./3 - C)W5
PARCEL # 92(0x.50\0G(00, Commercial IL Residential 0
SITE LOCATION Tenant/Owner /-brbeLi tPhone
Address/City/State/Zip 334/00 CSO -! ' /1 Vt 3 v \ Ii y i wA
Nature of Work_kid ancl volTafet � C Project Valuation:$ I 00
V112,64C1 S - w —der vernoobt
APPLICANT (�
Name � � lP S
• Address/City/St/Zip AVe 6.
Contact Person 0 [I L: V'C Phone oZS3 612(0"2290 Fax ' Th g -( tsG
CONTRACTOR
Company Name TOATIO-� l.
vle ile/r)
Address/City/St/Zip_2j0:7 /0 � r , W74 q(cya y
Contact Person e /l t- (;aYr Phone 25.&-_92‘ -22c3o Fax -9.02-(p I5C
State L&I Contractor Registration# PA—`—VCT ��i 1CI1. Exp.Date /0/5/0w
(Card must be presented)
PLEASE SUBMIT THREE (3) SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" X 36"
DISCLAIMER:I certify,under penalty of perjury,that the information furnished by me is true and correct to the best of my knowledge and further that I am authorized by the owner of the above premises to perform the work
for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in investigation and defense of such claim),which may be
made by any person,including the undersigned,and filed against the City of Federay Way 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.
Owner/Agent Date 9/�9/U 3
FPS.Aee
REVISED 5/19/99