14-103748CITY of RBC MD
Federal Way JUL 2 5 2014
j' y QF FEDERAL WAY
PERMIT NUMBER — L &CD3
PERMIT APPLICATION
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
909 S 336th Street Federal Way, WA
#202
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 4000.00
9 2 6 4 8 0- 0 1 5 0
TYPE OF PERMIT
[--]BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 1XRRE PREVENTION
NAME OF PROJECT
Signature Home Health
Relocate Fire Alarm devices for tenant improvements for Suite #202, as
PROJECT DESCRIPTION
Detailed description of work to
per drawings
be included on this permit only
PROPERTY OWNER
NAME
Omni Office Building
PRIMARY PHONE
MAILING ADDRESS
909 S 336th Street
E-MAIL
CITY
Federal Way
STATE I
WA
ZIP
NAME
Security& Electric, Inc
PHONE
3 638-1792
MAILING ADDRESS
P O BOX 7171
EMAIL
scott@meridiansecurity.biz
CONTRACTOR
CITY
Kent
STATE
WA
ZIP
98042
FAX
253-638-0396
WA STATE CONTRACTOR'S LICENSE #
Meridse022d5
EXPIRATION DATE
03/ 25 /201
FEDERAL WAY BUSINESS LICENSE #
20-06-100155-OOBL
NAME
PRIMARY PHONE
Meridian Security Electric Inc
253-638-1792
MAILING ADDRESS
P O BOX 7171
E-MAIL
scott@meridiansecurity.biz
APPLICANT
CITY
Kent
STATE
WA
ZIP
98042
FAX
253-638-0396
PROJECT CONTACT
NAME
Scott Harris
PRIMARY PHONE
253-638-1792
MAILING ADDRESS
P O BOX 7171
EMAIL
scott@meridiansecurity.biz
(The individual to receive and
respond to all correspondence
cITY Kent
WR
'58042
M-638-0396
concerning this application)
PROJECT FINANCING
NAME
E] 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 apart of this application.
SIGNATURE: DATE 07/24/2014
r
PRINT NAME: Scott Harris
Bulletin #100 —January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project. Don include existin fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
4,000.00
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Dori include existtn lures to remain.
BATHTUBS dorTub/Shower Combo
LAVS Hand Sinks
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/ utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
4,000.00
$
EXISTING/PREVIOUS USE
LOT SIZE (In Squwe Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes X No
❑ Yes ❑ No
Bulletin #100 —January 1, 2013 Page 2 of 3 k:AHandouts\Permit Application