14-103209 • I
arr OF _.,,4144%,„,
.. PERMIT APPLICATION
Federal Way RECEIVED
4 ( Q 3 2 n JUL 01 2014
PERMIT NUMBER ( 1 _
TARGET DATE
CITY OF FEDERAL WAY
SITE ADDRESS SUITE/T(!DS
34100 9th Ave S
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
1321800020 _
2565.65 -
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ENGINEERING IN FIRE PREVENTION
NAME OF PROJECT Salmolux Inc.
Install new Fire Panel,one addressable module
PROJDESCRIPTION
Detailed ECT description of work to Site Contact: Ray Crockett(253)874-2026
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER KRS Holdings LLC 253 874-2026
MAILING ADDRESS E-MAIL
34100 9th Ave S
CITY STATE ZIP
Federal Way WA
NAME PHONE
TYCO INTEGRATED SECURITY LLC 206-774-9499
MAILING ADDRESS E-MAIL
CONTRACTOR 11124 NORTH CREEK PKWY N#105 jennifer@nwpermit.com
CITY STATE ZIP FAX
Bothell WA 98011
WA.STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
TYCOIIS88600 09/2014
NAME PRIMARY PHONE
Northwest Permit Inc(AGENT ONLY)Jennifer Covello
APPLICANT MAILING ADDRESS E-MAIL
1345 Gulf Rd jennifer@nwpermit.com
CITY STATE ZIP FAX
Pt.Roberts WA 98281
- - ------- NAME PRIMARY PHONE
PROJECT CONTACT Northwest Permit Inc(AGENT ONLY)Jennifer Covello 206-774-9499
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 1345 Gulf Rd jennifer@nwpermit.com
concerning this application) CITY STATE ZIP FAX
Pt.Roberts WA 98281
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.
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 out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied t he city as a part of s application.
SIGNATURE: DATE
PRINT NAME: GR.✓A. Al(aLu-el
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application