18-100923 RECEIV
A„,,,,,,i..,_.4..,... PEiemIT APPLICATION
Federal Way FEB _I�RI2Ul&NTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+Dermitcenter(ircitvoffederalway.com
�y COMMUNITY DEVE OPMENT
PERMIT NUMBER / 6 - / 0 o 67
C/�.,[ 3 - FP
TARGET DATE `
SITE ADDRESS SUITE/UNIT#
35236 2nd Ave SW B
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1600 3021Q49024 -
TYPE OF PERMIT ❑ BUILDING D PLUMBING D MECHANICAL ❑ DEMOLITION D ENGINEERING I FIRE PREVENTION
NAME OF PROJECT Village Green Ret. New Cottages/townhome
Install AES 7788F Radio
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
Monte& Diane Powell 253-927-3700
PROPERTY OWNER MAILING ADDRESS MI
35419 1st Ave S .immAa�villagegreenretirement.com
CITY STATE dg003
Federal Way WA
NAME PHONE
MR Industries LLC dba Infinity Fire Protection 877-899-3473
MAILING ADDRESS E-MAIL
CONTRACTOR 18833 Renton-Maple Valley RD SE LBrowning@Infinity-fire.com
CITY STATE ZIP FAX
Maple Valley WA 98038 877-806-3473
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
INFINFP861RT/INFINFP853CS 12/31/7018 20-10-102173-00-BL
NAME PRIMARY PHONE
Lita Browning/Infinity Fire Protection 877-899-3473
APPLICANT MAILING ADDRESS E-MAIL
18833 Renton-Maple Valley Rd SE LBrowning@Infinity-fire.com
CITY STATE ZIP FAX
Maple Valley WA 98038 877-806-3473
NAME PRIMARY PHONE
PROJECT CONTACT Lita Browning 877-899-3473
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 18833 Renton-Maple Valley Rd SE LBrowning@Infinity-fire.com
concerning this application) CITY STATE ZIP FAX
Maple Valley WA 98038 877-806-3473
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$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 harmles the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense h claim),which may be made by any person,including the undersigned, and filed against the city,
but only where such clai • • -es out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to • t • • •a. a•plication.
SIGNATU' /`��� DATE 2/23/18
PRINT NAME: Lita Browning 41111.
Bulletin#100—January 29,2016 Page 1 of 2 k:AHandouts\Permit Application