18-104580r , RECEIVE®
a� SEP 2 7 2018
PERMIT APPLICATION
ep'' Way PERMT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
eraCITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + nermitcentevacitvoffederalway.com
COMMUNITY DEVELOPMENT
PERffiT NIIMBER
/6 _ !® Y5 SxO — F
VV TARGET DATE
BITE ADDRESS
BUTTE/UNIT @
35401 PACFIC HWY S
PROJECT VALUATION
ZONING
A88MAWR'S TAR/PARCEL 0
$ 1198
2 9 2 1 0 4_ 9 1 2 8
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION
NAME OF PROJECT
STORQUEST
PROJECT DESCRIPTION
ADD 2 NOTIFICATION DEVICES FOR SYSTEM UPGRADE.
Detailed description of work to
be included on this permit only
NAME
SOUTH FEDERAL WAY MINI LLC
PROLUM PHONE
PROPERTY OWNER
SLING ADDRESS
E-MAIL
CITY
STATE I
ZIP
NAME
SMITH FIRE SYSTEMS
PHONE
253 248-2004
1106 ADDRESS
4TH AVE ECS
OTTJ@SMITHFIRE.COM
CONTRACTOR
TACOMA
WA
zw
98424
F�
(253) 926-0726
WA STATE CONTRACTOR'S LICENSE 9
SMITHFS861RS
EXPIRATION DATE
12/ 10 18
FEDERAL WAY BUSINESS LICENSE 9
198700005500BL
NAME S/A
PRIMARY PHONE S/A
APPLICANT
MAILING ADDREse SIA
E-MAIL S/A
CITY S/A
STATE
ZIP
FAX S/A
PROJECT CONTACT
NAME SCOTT JERKE
PR1M1ARY PHONE S/A
S/A
E-MAIL S/A
(The individual to receive and
respond to all correspondence
CrIT S/A
STATE
zn,
FAX S/A
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAIIJNG ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. Z cerlffly that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certgj 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 ci , including its officers and employees, upon the accuracy of the
ir{formatfon supplied to the city as apart of this applicatlo
SIGNATURE: "� DATE 9/25/18
PRINT NAME.• SCOTT JERKE
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\HandoutslPermit Application