14-103440 RECEIVED A
•
CITY UP,/•••.,: -.- JUL 1 0 2014
PERMIPAPPLICATION
Federal Way
CITY OF FEDERAL WAY
/ 1/ CDS
PERMIT NUMBER ta
_ ± 12 3 (-"iy-r' 0/ - f*
TARGET DATE
SITE ADDRESS
SUITE/UNIT#
35703 16th Ave S bldg A
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 5,710 7, 9 _ 1 0 4 _ 9 1 0 7
TYPE OF PERMIT
0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING lS1 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
--_ LL NAME CITY I STATE 1 I ZIP
--- -
Froula Alarm Systems, Inc. PHONE
206-575-1962
MAILING ADDRESS E-MAIL
CONTRACTOR 861 Industry Drive kris@froulasolutions.coln
CITY STATE ZIP FAX
trik TAW,ila WA 98188 206-575-8168
IP WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FRt)t,'1,r�Si??i / / 19-98-105635-00-BI,
NAME
PRIMARY PHONE
same as above
APPLICANT MAILING ADDRESS E-MAIL
CITY 1 STATE ZIP FAX
NAME
PROJECT CONTACT Kristopher Conner PRIMARY
�53-753-66PHON6660
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 861 Industry Drive kris@froulasolutions.com
concerning this application) CITY STATE ZIP
Tukra i Ea \ A 1)8 i 88 FAX
--------------
NAME ---._-- -_
PROJECT FINANCING0 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 10Handouts\PerTnit Application