16-105971 Rirt
ED
•
CITY of
Jrn ?.016 PERMIT APPLICATION
Federal Way CITY OF FEDERAL WAY 3 00( 3
/ _ CDS -
/
PERMIT NUMBER I n / o S q ? / /�—
!!! I TARGET DATE
SITE ADDRESS SUITE/UNIT#
33400 9th Ave S Federal Way, WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL#
$ 1 ,100 9 2 6 5 0 1 _ 0 0 6 0
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL ❑DEMOLITION 0 ENGINEERING • FIRE PREVENTION
NAME OF PROJECT Golden Stone Properties LLC
Installing an AES intellitap&AES radio transmitter to existing fire alarm panel(Fire Lite MS 9200)
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER Golden Stone Properties LLC 253-838-4100
MAILING ADDRESS E-MAIL
33400 9th Ave S,Suite 206
CITY STATE ZIP 98003
Federal Way WA
NAME PHONE
Washington Alarm 206-328-1800
MAILING ADDRESS E-MAIL
CONTRACTOR 2030 Airport Way S install@washingtonalarm.com
CITY STATE ZIP FAX
Seattle WA 98134 206-322-7214
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
WASHIAI282C3 15 05 2017 20-00-101629-00-BL
NAME PRIMARY PHONE
Manny Ornelas 206-436-5301
APPLICANT MAILING ADDRESS E-MAIL
permits@washingtonalarm.com permits@washingtonalarm.com
CITY STATE ZIP FAX
Seattle WA 98134 206-322-7214
NAME PRIMARY PHONE
PROJECT CONTACT Manny Ornelas 206-436-5301
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence Permits@washingtonalarm.com permits@washingtonalarm.com
concerning this application) CITY STATE ZIP FAX
Seattle WA 98134 206-322-7214
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.
l 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 o of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the cit .- f this .L •tion.
SIGNATURE: / DATE 12/16/2016
PRINT NAME: Ma as
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application