16-104800 RECEIV. _ I O 4 0o
""°` SEP 2 8 2016 PERMIT SF MF CO ME PL DE EN FP
Federal Way
COMMUNITY2607*FAx
��F FEDE PLICATION
253-835-2607•FAX 253-
www.c9uoffederalwau.com CDS
SITE ADDRESS SUITE/UNIT#
28502 24th Ave So, Federal Way,WA
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$8,250.00 3 3 2 2 0 4 - - _
TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ® FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) Bardales Home
Fire sprinkler system for single family residence
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PHONE
PROPERTY OWNER NAME Josue Bardales 206-786-4474P
MAILING ADDRESS E-MAIL
4326 South 332nd PI
CITY Federal Way STATE ZIP 98001
'AME PRONE
Performance Fire Protection 360-913-0488
MAILING ADDRESS E-MAIL
CONTRACTOR 122 90th st NE mitchs@p-fp.com
C�Tulalip STATE ZIP 98271 FAX 360-657-0040
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PERFOFP934Q6 0 7 / 0 7 / 1 7
PHONE
NAME Performance Fire Protection 360-913-0488
APPLICANT
MAILING ADDRESS E-MAIL
122 90th st NE mitchs@p-fp.com
CITY Tulalip
STATE
A ZIP 98271 FAX 360-657-0040
PROJECT CONTACT NAME Mitch Stemm PHONE
(The individual to receive and 360-913-0488
respond to all correspondence MAI ING ADDRESS E-MAIL
concerning this application) 122 90th St NE mitchs@p-fp.com
OITY Tulalip STATE ZIP 98271 FAX 360-657-0040
ALTERNATE CONTACT NAME: PHONE E-MAIL
Gary McDaniel 360-689-9324
PROJECT FINANCING NAME
OWNER-FINANCED
Required value of$5,000 or more
(RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP 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. f/es V r�:IJ DATE `/2s//fr
PRINT NAME: Mitch Stemm
Bulletin#100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application