10-105379 CITY OF FCEIVE •
Federal Way PERMIT SF MF CO ME PL DE EN FP
COMMUNITY DEVELOPMENT Stii ES 4 APPLICATION �,,�
253-835-2607•FAX 253-835-2609CCwUU
www.ci�ygy� FEDERAL WaltP' 4Py10--
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SITE ADDRESS SUITE/UNIT#
515 South 312th Street
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 42,000 0 gf 2 t f A _ o
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING X FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) Saint Luke's Church
Adding new classroom wing to Fire Alarm System and upgrading
PROJECT DESCRIPTION FACP.
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
r NAME Pacific Fire 8s Security Inc. PHONE 206-788-3819
O`L MAILING ADDRESS 828 Poplar PI S E-MAIL
CONTRACTOR chrisrra pacificfiresecurity.com
CITY Seattle STATE ZIP 98144 FAX
WA
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
PACIFFS914MF 12/31 /2010 20 06 103860-00BL
NAME Same as Electrical Contractor PHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME Chris Rogers PHONE
(The individual to receive and
MAILING ADDRESS SAME AS ABOVE E-MAIL
respond to all correspondence
concerning this application) chrisr'apacific£uesecurity.com
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAMEEl 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 t e City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in
the investigation and defense of such laim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim a.,,es ou of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city ras a pa this application. !�
SIGNATURE: DATE / 2"/ Ti �`/ WI0
Bulletin#100—April 14,2010 Page 1 of 3 k:AHandouts\Permit Application