01-101939-4 *k.
MY OF
V Y
MAY 16 2001
vt + BUILLDING DEPT. AY
114 ;'
BuaDiNG DnrmoN
33530 First Way South
Federal Way, WA 98003
(253) 6614000
Fax (253) 6614129
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: %L 17
PARCEL# -�5y2,o C I/ l
Commercial ''Q Residential 0
SITE LOCATION
Tenant/Owner
Address/City/State/Zip
Sfi
;
Nature of Work 46,L a a n f l Project Valuation: $_-
r-3 +0 e x p s+ S 5
APPLICANT
Name t T Gni r' a v�
Address/City/St/Zip /
Contact Person L2 Phone �o�. �� `��� h / �8l Fax
CONTRACTOR
Company Name /3'1 / 7� /� r <- ��. S 7 -le m -75,
Address/City/St/Zip
Contact Person �L ILI An-fI'L Phone
Fax
State L & I Contractor Registration # -_ J -21 -- i f/ / G % Exp. Date -2 /
(Card must be presented)
PLEASE SUBMIT THREE (3) SETS OF DRAWINGS AND CUT SHEETS, PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 2411 X 36"
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 1 am authorized by the owner of the above premises to perform the 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 incurred in investigation and defense of such claim), which may be
made by any person, including the undersigned, and filed against the City of Federay Way 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 cityis�a part of this application.
Owner/Agent _
FPS.App
REVISED 5/19/99
Date