17-106102 RECEIVED
CITY OFAPERMIT APPLICATION
DECFederal Way 2 8 2017
OM UNTY DEVELOPMENTF FEDERAL
PERMIT NUMBER i — / 0 6 / D ok - Fie"
TARGET DATE
SITE ADDRESS SUITE/UNIT#
34719 6th AVE. SOUTH, FEDERAL WAY, 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 3,330.60 2 0 2 1 0 4 - 9 1 7 8
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING NI FIRE PREVENTION
NAME OF PROJECT EVERGREEN EYE CENTER
INSTALL NEW WIRING AND TRIM, CUSTOMER TO PROVIDE PROPRIETARY"EST"
PROJECT DESCRIPTION DEVICES AND NOTIFICATION. RELOCATE EXISTING DEVICES.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER GUARDIAN CAPITAL MANAGEMENT (253)370-2037
MAILING ADDRESS E-MAIL
34719 6TH AVE. SOUTH
CITY STATE ZIP
FEDERAL WAY WA 98003
NAME PHONE
ALARM CENTER INC. (800) 354-1555
MAILING ADDRESS E-MAIL
CONTRACTOR PO BOX 3407 justin(a�alarmcenterinc.com
CITY STATE ZIP FAX
LACEY WA 98509
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ALARMCI055CW 02/ 15 / 18 20-00-101-452-00-BL
NAME PRIMARY PHONE
SAME AS ABOVE
APPLICANT MAILING ADDRESS E-MAIL
SAME AS ABOVE
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT JUSTIN FIESS (800)354-1555
(The individual to receive and MAILING ADDRESS E- L
respond to all correspondence PO BOX 3407 Justin@alarmcenterinc.com
concerning this application) CITY STATE ZIP FAX
LACEY WA 98509
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 to the city as a part of this application.
SIGNATURE: �40„bb ` /
/ ZG •7 7
PRINT NAME: STIN FIESS `
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(co.)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or Tub/shower combo( LAVS(Hand sinka) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
M(Yes❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
w $" y 6s
FIRST FLOOR(or Mobile Home)
COVERED ENTRY
................................................................................................................................................................................................
DThr <
GARAGE ❑ CARPORT ❑
................................................................................................................................................................................................
BXISTIRO PROPOSED TOTAL
Area Totals
"
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION Area Occupancy Groups) Construction #of Additional Information
in Square Feet Type Stories
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
Area Construction #of
AREA DESCRIPTION Occupancy Groups) Additional Information
In Square Feet pe S s
TENANT tiREA ONLY
14F,�p
Bulletin#100-January 1,2013 Page 2 of 3 k:\Handouts\Permit Application