14-103448 Prim F
art OF JUL 1 12014 PERMI APPLICATION
Federal Way
CITY OF FEDERAL WAY
CDS (�j
PERMIT NUMBER / _ 0 3 i X _ rp
r-- _)
I / LJ TARGET DATE
SITE ADDRESS SUITE/UNIT#
35703 16th Ave S bldg F
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 3.850 9 2 I 0 4 _ 9 1 0 7
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING ]FIRE PREVENTION
NAME OF PROJECT \
Install fire alarm system in new apartment building.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
i
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
I-I i is Alarm Systems, Inc. 206-575-1962
MAILING ADDRESS E-MAIL
CONTRACTOR 861 Industry Drive kris@,froulasolutions.com
CITY STATE I ZIP FAX
Tukwila WA 98186 206-575-8168
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
FROULAS I22DS 19-98-105635-00-BI
NAME -._.. PRIMARY PHONE -�. ...
same as above
APPLICANT MAILING ADDRESS E-MAIL
CITY I STATE ZIP FAX
\ I
N
PROJECT CONTACT Kristopher Conner 253-753-6660E P
(The individual to receive and MAILING ADDRESS EAAIL
respond to all correspondence 861 Industry Drive kris@,froulasolutions.com
concerning this application) CITY STATE ZIP FAX
Tukwila W A 98 9 88 206-575-8168 1
..._.....__ 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 7/8/2014
PRINT NAME: Kristopher Conner
Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application
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