12-104904Crr,OF:&
Federal Way PERMIT SF MF
COMMUNITY DEVELOPMENT SERVICES APP LI CATI ONCEIV E D
253-835-2607• FAX 253-8352609
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OCT 2 6 2012
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CO ME PL DE EN G
SITE ADDRESS
SUITE/UNIT #
848 S 320th Street
CITY OF FEDERAL WAY
N/A
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
$ 37,000.00
0 8 2 1 0 4 _
9 2 2 2
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING i?] FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
Federal Way Library Replacement
Installation of new wet fire sprinkler system throughout
new building
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
King County Library System
425-369-3200
MAILING ADDRESS
E-MAIL
960 Newport Way NW
CITY
Issaquah
STATE
WA
ZIP
98027
NAME
Fie Sprinklers Incorporated
PHONE
253-826-0099
MAILING ADDRESS
1524 45th Street E - Suite 102
E-MAIL
jay@firesprinklersinc.com
CONTRACTOR
CITY
Sumner
STATE
WA
ZIP
98390
FAX
253-826-1033
WA STATE CONTRACTOR'S LICENSE #
FIRESI*988RJ
EXPIRATION DATE
12 11 14
FEDERAL WAY BUSINESS LICENSE #
20 -05 -100633 -00 -BL
NAME
Fire Sprinklers Incorporated
PHONE
253-826-0099
MAILING ADDRESS
1524 45th Street E - Suite 102jay@firesprinklersinc.com
E-MAIL
ay fires rinklersinc.com
APPLICANT
CITY
Sumner
STATE
WA
ZIP
98390
FAX
253-826-1033
PROJECT CONTACT
(7he individual to receive and
NAME
Jay Kolbe
PHONE
253-826-0099
MAILING ADDRESS
1524 45th Street E - Suite 102
E -MAH.
jay@firesprinklersinc.com
respond to all correspondence
concerning this application)
CITY
Sumner
STATE
WA
ZIP
98390
FAX
253-826-1033
ALTERNATE CONTACT NAME:
reg Moffett
PHONE
253-826-0099
E-MAIL
greg@firesprinklersinc.com
PROJECT FINANCING
Required value of $5,000 or more
NAME
N/A
OWNER -FINANCED
MAILING ADDRESS, CITY, STATE. ZIP
PHONE
(RCW 19.27.095)
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.
1 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
10/26/12
PRINT NAME. Jay Kolbe
Bulletin #100 — January 1, 2011 Page l of 3 k:\Handouts\Permit Application