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14-103443 RECEIVED •102014 CITY OF110/1.1.40.. PERMI APPLICATION Federal Way CITY OF FEDERAL WAY CDS PERMIT NUMBER / / b 3 11, 1 3_ _\ F TARGET DATE SITE ADDRESS I SUITE/UNIT# 35703 16th Ave S bldg .E PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ 5.710 2 9 2 1 0 4 _ 9 1 0 7 TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING E'1 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 PHONE Froula Alarm Systems. Inc. 206-575-1962 MAILING ADDRESS E-MAIL CONTRACTOR 861 Industry Drive kris@froulasolutions.com CITY STATE ZIP FAX Tukwila WA 98188 206-575-8168 WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# FROULA5122DS 19-98-105635-00-BL NAME PRIMARY PHONE -same as above APPLICANT MAILING ADDRESS E-MAIL CITY 1 STATE ZIP FAX NAME PRIMARY PHONE PROJECT CONTACT Kristopher Conner 253-753-6660 MAILING ADDRESS E-MAIL (The individual to receive and respond to all correspondence 861 Industry Drive kris@froulasolutions.com concerning this application) CITY STATE ZIP Tukwila A'.A 98188 FAX NAME PROJECT FINANCING 0 OWNER-FINANCED Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP (RCW 19.27.095) 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