11-101072 44116. It - ' 0 ( ° 7�
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PERMIT • MF CO ME PL DE ENFede -
COMM �Y2y�1A�� �ERVAPPLICATION
253-85-2607•FAX 253-837 R 2 2 nAll GU,1sSv-8a
SITE ADDI OF FEDERAL WAY SUITE/UNIT#
616 S. 48TH ST,FE$WAY,WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
8000 9264800020
-
TYPE OF PERMIT 1:1BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ENGINEERING 04 FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name) DSHS FEDERAL WAY
REPLACE THE EXSITING FACP AND REMOTE ANNUNCIATOR DUE TO PANEL FAILURE. THE EXISTING
PROJECT DESCRIPTION
Detailed description ofwork to
2-WIRE CONVENTIONAL SMOKE DETECTORS WILL ALSO BE REPLACED TO BE COMPATIBLE WITH THE
wo
be included on this permit only NEW FACP. EXISTING ZONING WILL REMAIN INTACT. THE EXISTING SMOKE DETECTOR WIRING WILL
REMAIN AS IS. ALL SMOKE DAMPERS,PULLS,NO I IFICATION DEVICES,&BOOSTER PANEL WILL REMAIN
Ut W\LTERFD- _-- _ __
NAME PRIMARY PHONE
PROPERTY OWNER AMLM LLC
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAMESMITH FIRE SYSTEMS MANAGEMENT PHONE 253-248-2004
11 6 5MAILG 4TH AVE E E- SJERKE@SMITHFIRE.COM
CONTRACTOR
CITY 1 STATE ZIP FAX
TACOMA WA 98424 253-926-0726
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
SMITHFS946LO 6 / 20 /2012 200610470900BL
NAME SMITH FIRE SYSTEMS MANAGEMENT PHONE 253-248-2004
APPLICANT MAILING
1 06 ADDRESS AVE E E-MAIL JERKE@SMITHFIRE.COM
CITY TACOMA STATE
IP 98424 FAX 253-926-0726
PROJECT CONTACT NAME PHONE
SMITH FIRE SYSTEMS MANAGEMENT 253-248-2004
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application) 1106 54TH AVE E SJERKE@SMITHFIRE.COM
CITY STATE Zn?
TACOMA WA 98424 FAX 253-926-0726
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 cert(fy 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.
pr
iJJM
SIGNATURE: `` v DATE 3/22/11
ERKE
PRINT NAME: SCOTT J
Bulletin#100-January 1,2011 Page 1 of 3 k:\Iandouts\Permit Application
• •
r
VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided)
Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing 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
Indicate how many of each type of facture to be installed or relocated as part of this project. Do not include existing fudures to remain.
DISHWASHERS
BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING
RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Uduty) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAlr 1t1X.T TILES,.
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ 8000
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes LSINo
FOR OFFICE USE
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
r ,I,I v '' a ,, mss,
FIRST FLOOR(or Mobile Home)
COVERED ENTRY —.
GARAGE 0 CARPORT ❑
r 0 a t:-
EXISTING PROPOSED TOTAL
Area Totals
r
ESTIMATED SELLING PRICE$ #OF BEDROOMS
i
� ate... E..... ,
Construction #of Additional Information
AREA DESCRIPTION Area Occupancy Group(s)
in vara Feet .,, Stories
ADDITION
,a,
AREA DESCRIPTION Area Occupancy Group(s) Construction #of
in .uare Feet Stories Additional Information
awaa z • p
TENANT AREA ONLY
-g 1, fig'_
Bulletin#100—January 1,2011 Page 2 of 3 k:\Ilandouts\Permit Application