18-104560CITY OF 4%L —
Federal Way PERMIT AP *WJON
PERMIT NUMBER
13 iQ +500 _r7(�> SEP 2,62018
CITY F COM UNDIIY DEV F1 nalu=►err
SITE ADDRESS: 34210 9TH AVE SOUTH
SUITE/UNIT/SPACE #
SUITE 110
PROJECT VALUATION
$ 3500.00
ASSESSOR'S TAX/PARCEL #
9264800090
CURRENT/PROPOSED USE
PROJECT NAME
(Tenant or Homeowner Last Name)
NW PUMP
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
ADD 6) FIRE ALARM AUDIO/VISUAL NOTIFICATION DEVICES
TO EXISTING FA SYSTEM, DUE TO NEW ROOMS BEING ADDED.
PROPERTY OWNER
NAME
BREIT IND CANYON WA1 W03 LLC
PRIMARY PHONE
_
MAILING ADDRESS
34200 9TH AVE S
E-MAIL
CITY
FEDERAL WAY
STATE
WA
I ZIP
98003
FAX
ELECTRICAL
CONTRACTOR
NAME
WESTERN STATES FIRE PROTECTION
PRIMARY PHONE
425) 881 _ 0100
MAILING ADDRESS
14690 NE 95TH ST STE 101
E-MAIL
jules.mayer@wsfp.us
CITY
WA
98052
425) FAX
3030
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
WESTESF906P1 12 31 18
FEDERAL WAY BUSINESS LICENSE #
19 -99 -106476 -00 -BL
APPLICANT
NAME
SAME AS ELEC CONTRACTOR
PRIMARY PHONE
_
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
JULES MAYER
PRIMARY PHONE
425) 429 _ 4240
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 a part of this application.
SIGNATURE: DATE 09/26/2018
PRINT NAME: JULES MAYER
Bulletin #160—January I, 201 3 Pa'_'c I of 2 UHandouts\F,lectrical Permit Application