18-102753 RECEIVED
CITY OF SUN Z 2 2018 PERMIT APPLICATION
Federal Way PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
CITY OF FEDERAL WAY 253-835-2607+FAX 253-835-2609+permitcenterrcityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER / 8 _ ° al 7 c _
/ TARGET DATE
SITE ADDRESS SUITE/UNIT#
33705 9TH AVE S FEDERAL WAY WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 1800.00
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING M FIRE PREVENTION
NAME OF PROJECT 1032L - CAMPUS BUSINESS CENTER RADIO ADD
PROJECT DESCRIPTION INSTALLATION OF FIRE ALARM COMMUNICATOR
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
CAMPUS BUSINESS CTR 253.272.4499
PROPERTY OWNER MAILING ADDRESS E-MAIL
PO BOX 1316 sarahb@simonjohnsonllc.com
ZIP
TACOMA WA 98401
NAME
E-SQUARED SYSTEMS LLC 2
2553.3.
284.3707
MAILING ADDRESS E-MAIL
CONTRACTOR PO BOX 731227 Iindseyl@e2systemsllc.com
CITY STATE ZIP FAX
PUYALLUP WA 98373
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ESQUASL963BR 20-05-103381-00-BL
NAME
E-SQUARED SYSTEMS LLC PRIMARY PHONE
253.284.3707
MAILING ADDRESS
APPLICANT PO BOX 731227 lindsMAILeyl@e2systemsllc.com
CITY STATE ZIP FAX
PUYALLUP WA 98373
NAME LINDSEY LESLIE PRIMARY PHONE
PROJECT CONTACT 253.284.3707
(The individual to receive and MAILING ADDRESSE-MAIL
respond to all correspondence PO BOX 731227 lindseyl@e2systems11c.com
concerning this application) CITY STATE ZIP FAX
PUYALLUP WA 98373
NAME
PROJECT FINANCING D OWNER-FINANCED
When value is$5,000 or more 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.
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 tit' plication.
•
SIGNATURE: ..z �. � DATE 61a I/ 1?-s
PRINT NAME: L . _ _ ..
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application