09-104798 t � , . * i
CITY OF
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES DLL ; v i',' 'I SF MF CO ME EL PL DE E FP
33325 8FEDERAL
ESDUTH•PO-9718 8 A p P L MCAT.]O N
FEDERAL WAY;WA 98063-9718 W
253-835-2607•FAX253-835-2609 •
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wwwdlyoffederalwa OF FEDERA
The following is required information-nplete application will not be accepted. Please print legibly(i ink)or type.
MI PROPERTY INFORMATION
SITE ADDRESS 501 S. 336Th ST., BUILDING 2, SECOND FLOOR SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 9264800240 LOTSIZE(s17
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) FOUNTAIN PLAZA
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT BUILDING PLUMBING MECHANICAL
DEMOLITION ELECTRICAL ENGINEERING x FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
THE SCOPE OF THIS PROJECT IS TO ADD NOTIFICATION AND ADDRESSABLE DEVICES FOR THE PURPOSE OF TENANT IMPROVEMENT.
PROJECT NAME(Name of Business or Owner Last Name)
FOUNTAIN PLAZA BfLTTOIN
• PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER FSP FEDERAL WAY CORP
MAILING ADDRESS (-11Y,STATE,ZIP E-MAIL ADDRESS
401 EDGEWATER PL., #200 WAKEFIELD, MA 01880-6210
CONTRACTOR COMPANY NAME APPLICAN I NAME OFFICE PHONE
SMITH FIRE SYSTEMS MANAGEMENT,LLC. SCOTT JERKE (253) 248-2004
MAILING AUDHLSS 0 IY,STATE,ZIP CELL PHONE
1106 54TH AVE E. TACOMA, WA 98424
Cl IY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRAI ION DA IE FAX NUMBER
200610470900BL 12/31/08 (253) 926-0726
CON TRACTOR'S REGIS.]RATION NUMBER EXPIRA I ION DA TE E-MAIL ADDRESS
SMITHFS946L0 6/20/10 SJERKE@SMITHFIRE.COM
APPLICANT COMPANY NAME APPLICANI NAME OFFICE PHONE
SMITH FIRE SYSTEMS MANAGEMENT, LLC. SCOTT JERKE (253) 248-2004
MAILING ADDRESS CITY,SLATE,ZIP CELL PHONE
1106 54TH AVE. E. TACOMA, WA 98424
HELM IONSHIP TO PROJECT FAX NUMBER
Architect Tenant Agent xOther CONTRACTOR
(253) 926-0726
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT SCOTT JERKE (253) 248-2004 SJERKE@SMITHFIRE.COM
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STA I L,LIP PHONE
II DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUES VALUE OF PROPOSED WORK S 6,900
SPRINKLERED BUILDING? YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? YES NO
WATER SERVICE PROVIDER LAKEHAVEN HIGHLINE TACOMA PRIVATE(WELL)
SEWER SERVICE PROVIDER LAKEHAVEN HIGHLINE PRIVATE(SEPTIC)
* 0 S
L
• PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
14,781
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED OR UNCOVERED?)
GARAGE CARPORT
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
WED IANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICAT
AIR HANDLING UNITS EVAPORATIVE IS L,LERS G' ' ' OUTLETS WOODSTOVES
BBQS FANS I GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INS"TS HOOD Comme Gall
COMPRESSORS FURNACES R
DUCTS GAS L• S FRI .SYSTEMS
PLUMBING
BATHTUBS (or Tub/Shower Co • LAVS (Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING F'.• AINS SHOWERS WATER CLOSETS rronet)
EL •`C WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that 1 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(inclu•-g costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which ma •-made by any person ncl ding- 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 accu of the information s •pli-•to the city as a part of this application.
/
SIGNATURE: , c A-..c---___, DATE / Z -0 2'- U 7'
Property Owne and/or Authorized Agent
•
NEW ADDITION ALTERATION REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES NO BASIC PLAN? YES NO
ZONING DESIGNATION CHANGE OF USE? YES NO
NEW ADDRESS REQUIRED? YES NO UP/SEPA/SU? YES NO
,
PLATTED LOT?
> ,..�.. ., __d._ ..� YES " .- NO <,,, w
DEMO PERMIT REQUIRED? . .., . . YES . . - > _ .�_
NO
Bulletin#100-August 16,2007 Page 2 of 4 k\\Handouts\\Permit
Application