97-10417897-- lO'VITA'"
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS97-0063
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318 ISSUED: 12/08/97
Federal Way, WA 98003 BY: FC2
661-4000
SITE ADDRESS: 29511 2ND PL SW
PARCEL NO.: 119600-3780
PROJECT DESCRIPTION: INSTALLING NEW FIRE SPRINKLER SYSTEM — RESIDENTIAL
OWNER CONTRACTOR LENDER
T JENSEN CONST INC WASHINGTON FIRE SPRINKLER
1911 SW CAMPUS DR SUITE 717 4226 108TH AVE E
FEDERAL WAY WA 98003 EDGEWOOD WA 98372
661-1717 253-841-7665
111111111 WASH IFSO9603
SPRINKLERS?........:? HOOD & DUCT?.......:? FEES:
# ZONES..........: 0 OTHER.....: FPS PRMT ISSUANCE- $ 20.00
FIRE ALARM SYSTEM?.:? EXTENT OF WORK...:? SPRINKLER FEE......* $ 81.00
# ZONES..........: 0
STANDPIPE?... .....:?
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
TOTAL FEES $ 101.00
INSPECTION RECORD
I
ALL PER ITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFOR ATI NFU NISHED BY ME IS'TRUE A C RRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT DATE
fps_prmt 07/01/92
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APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #
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Tenant Of known) �� ttV % D At,
Lot #
1"l
Building Owner's Name Address
Ci fill a* I State UJit 7.,
BUJLDINGDw=oN
33530 First Way South
Fcderal Way, WA 98003
(253) 661-4000
Fax (253) 661-4129
3
Tax #
Nature of Work -L,a [Av1 -4-- 1 VIS+g j1044-; n, 7YIF- i2 e On
Name (F,M,L)
Address
Contact Person
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Day Phone
Other Phone
Fax
Company Nam c ` !'
Address 4Loy
Ci
State
Z a-^
Contact Person 04
Phone
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Fax
Contractor's # (card must be presented 63
Expiration Date
Verified 0 Yes 0 No
LEGAL DESCRIPTION
P/ease Comn/ete_ Reverse Side
Name
Contractor Name
Contact
Address
Fax
Verified ❑ Yes
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33f:'s'v••'M.
Contractor Name
Address
MECHANICAL EVALUATION ONLY S
city
State
Zi
Contact
Phone
Fax
License #
Expiration Data
Verified ❑ Yes ❑ No
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MECHANICAL EVALUATION ONLY S
Fuel Type (electriclot r)
Gas Dryer
Water Closets
Sinks
Urinals
Lawn Sprinklers
Range
Bathtubs
Dish Washers
Drinking Fountains
Other
Gas Loa
Showers
Electric Water Heaters
Sumps
Furn > 100 B s
Fans
Lavatories
Washing Machine
Drains
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MECHANICAL EVALUATION ONLY S
Fuel Type (electriclot r)
Gas Dryer
Air Handling < = 10,000 CFM
15-30 Tons
Length of Gas Pi i
Range
Air Handling > = 10,000 CFM
30-50 Tons
Furn <100K BTk/1
Gas Loa
Unit Heater
50+ Tons
Furn > 100 B s
Fans
Miscellaneous
Fuel Tanks
Gas Hwt
Hood
Boilers
Above Ground
Conv B her
Duct Work
0-3 Tons
Under round
BBQ
Wood Stoves
3-15 Tons
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DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner of
the above premises to perf work for which permit application is made. I further agree to save harmless the City of Federal Way as to any claim (including costs, expenses, and
attorneys' fees in in i4ve4gation and defense of claims)O" may be made by any person, including the undersigned, and filed against the City of Federal Way, but only
where such claim ad outlof tfw reliance of the city, rotding itp(offioers and employees, upon the accuracy of the information supplied to the city as a part of this application.
Owner/Agent YuA)Date:
aunDWA"
RV4= WSW
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS97-0063
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318 ISSUED: 12/08/97
Federal Way, WA 98003 BY: FC2
661-4000
SITE ADDRESS: 29511 2ND PL SA
PARCEL NO.: 119600-3780
PROJECT DESCRIPTION: INSTALLING NEW FIRE SPRINKLER SYSTEM — RESIDENTIAL
OWNER CONTRACTOR LENDER
,T JENSEN.CONST INC WASHINGTON FIRE SPRINKLER
1911 SW -CAMPUS DR SUITE 717 4226 108TH AVE E
FEDERAL WAY WA 98003 EDGEWOOD WA 98372
�1-1717 253-841-7665
WASHIFS09603
SPRINKLERS?........:? HOOD & DUCT?.......:? FEES:
# ZONES..........: 0 OTHER.....: FPS PRMT ISSUANCE. $ 20.00
FIRE ALARM SYSTEM?.:? EXTENT OF WORK...:? SPRINKLER FEE......* $ 81.00
# ZONES..........: 0
STANDPIPE?.........:?
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
TOTAL FEES $ 101.00
INSPECTION RECORD
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFO AT FURNISHED BY E IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT DATE
fps_p mt 07/01/92