14-103447 CITY OF tE'VED P E R M I APPLICATION
Federal Way
3UL 10 2.014
PERMIT NUMBER-' i)C /¢ ilL( L J
v __[[ ! TARGET DAT
SITE ADDRESS
SUITE/UNIT#
35703 16th Ave S bldg E.
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 5,710 2 9 2 1 0 4 _ 1 0 7
TYPE OF PERMIT
0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING n FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION Install fire alarm system in new apartment building.
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME
t roula Alarm Systems,Inc. PHONE
206-575-1962
MAILING ADDRESS E-MAIL
CONTRACTOR 861 Industry r)riye kris@froulasolutions.com
CITY STATE ZIP FAX
Tukwi ._: 1 WA 98188 206-575-8168
WA STATE CONTRACTOR'S LICENSE q EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE a
FROULAS122D`. � , 19-98-105635-00-
NAME PRIMARY PHONE
same as above
APPLICANT MAILING ADDRESS E-MAIL
CITY ( STATE ZIP FAX
NAME
PROJECT CONTACT Kristopher Conner PRIMARY 6660
MAILING ADDRESS E![AIL
(The individual to receive and
respond to all correspondence 861 Industry Drive kris@froulasolutions.com
concerning this application) CITY STATAE i ZIP
Tukwila W 98 FAX
PROJECT FINANCING NAME
0 OWNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP
(RCW 79.27.095) PHONE
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