14-103449 OPCEIVE1)
CITY OF FERMI APPLICATIO
.11
Federal Way
JUL 1 0 2014
CINF\,FE�E A
PERMIT NUMBER / �V Cts i P
/// TARGET DATE /
SITE ADDRESS SUITE/UNIT#
35 703 i 611 ;eve 8
bldg C
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 3 850 9 i 0 9 1 0 7
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING f,1 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING En FIRE PREVENTION
NAME OF PROJECT
Insiall lire alarm iv stein ill Ilt iv :limr"i111Clll 11tlildili�'.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
romAlarm arm St ;teltts, inc
i . 206-575-1962
MAILING ADDRESS E-MAIL
CONTRACTOR 861 Industry Drive kris"a froulasolutions.com
CITY STATE ZIP FAX
I uila WA 98188 206-575-8168
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FROULAS122DS 19-98-105635-00-BL
NAME PRIMARY PHONE
Same as above
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT i- I sI Jpher Conner 2J3-753-6660
(The individual to receive and MAILING ADDRESS EMAIL
respond to all correspondence 861 Industry- Drive krlsla:fronlasolUtions.corn
concerning this application) CITY STATE ZIP FAX
l ukrvl!<I ANA 08188 206-575-8168
NAME
PROJECT FINANCING ❑ 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: DATE 7'` s''2014
PRINT NAME: Kristopher Conner
Bulletin#100—January 1,2013 Page I of 3 k:AHandouts\Permit Application