18-105228RECEIVED
CITY OF NOV O 5 201 PERMIT APPLICATION
� +
Federal Way PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
CrTY OF FEDERAL. WAY 253-835-2607 + FAX 253-835-2609 + PermitcenterOcitvoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER _ 5-2 d _ TARGET DATE
SITE ADDRESS
SUITE/UNIT N
30459 MILITARY ROAD SOUTH
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL M
$ 795.00
0 9 2 1 0 4_ 9 1 0 0
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING IN FIRE PREVENTION
NAME OF PROJECT
PAT'S PLUMBING
PROJECT DESCRIPTION
Installation of AES fire radio transmitter to FACP. Connection and testin .
Detailed description of work to
be included on this permit only
NAME
Linda J Peterson
PRIMARY PHONE
(253) 854-8040
PROPERTY OWNER
MAILING ADDRESS
30459 Military Road South
EMAIL
CITY
Federal Way
I STATE I
WA
ZIP
98003
NAME STANLEY CONVERGENT SECURITY SOLUTIONS INC.
DBA: ALARM CENTER
PHONE
(800) 354-1555
MAILING ADDRESS
EMAIL
CONTRACTOR
4500 3RD AVE SE #1
justin@alarmcenterinc.com
CITY LACEY
STATE
ZIP 98503
FAx
WA STATE CONTRACTOR'S LICENSE M
ALARMC%20JO
EXPIRATION DATE
04/20 i20
FEDERAL WAY BUSINESS LICENSE N
2 - 0 -101 -452 -00 -BL
NAME SAME AS ABOVE
PRIMARY (800) 354-1555
MAILING ADDRESS
SAME AS ABOVE
EMAIL
justin@alarmcenterinc.com
APPLICANT
CITY LACEY
STRA
Vv
ZIP 98503
FAX
PROJECT CONTACT
NAME JUSTIN FIESS
PRIMARY PHONE
(360) 252-1505
MAILING ADDRESS
4500 3RD AVE SE #1
E-MAIL
justin@alarmcenterinc.com
(The individual to receive and
respond to all correspondence
CITY
LACEY
STATE
WA
ZIP
98503
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $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 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 iocai, 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
irf'ormation supplied to the city as a part of this application.
SIGNATURE: DATE
/
PRINT NAME: JUSTIN FI SS
Bulletin #100 — January 29, 2016 Page 1 of 2 k:U3andouts\Permit Application