18-104975RECEIVED
'k OCT 2 2 2018 PERMIT APPLICATION
CITY OF
Federal Way CITY OF FEDERAL WAY PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
COMMUNITY DEVELOPMENT 253-835-2607 + FAX 253-835-2609 + permitcenter(&,cityoffederalway.com
PERMIT NUMBER _ , ® ` _ " TARGET DATE
SITE ADDRESS
BUTTE/UNIT X
35025 Enchanted Parkway S
PROJECT VALUATION
ZONINGASSESSOR'S
TAX/PARCEL X
$ 4,500.00
7
— — —1 8 5 2 9 5_ 0 0 3 0
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING PREVENTION
NAME OF PROJECT
`ff JFIRE
Federal Way Crossings Bldg. F Trd �(iX4�NiOl�e.
PROJECT DESCRIPTION
Replace Existing Fire Alarm System.
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
EMAIL
CITY
STATE I
ZIP
NAME
Fire Systems West, Inc.
PHONE
253-833-1248
MAILING ADDRESS
206 Frontage Rd N, Suite—C
EMAIL
service®firesystemswest.com
CONTRACTOR
CITY
PacificA
TE
ZIP
98047
FAX
WA STATE CONTRACTOR'S LICENSE X
FIRESWI055LW
EXPIRATION DATEFEDERAL
06 30 19
WAY BUSDIESS LICENSE X
19 -87 -000014 -00 -BL
NAME
Fire Systems West, Inc.
PRBURY PHONE
253-833-1248
MAILING ADDRESS
206 Frontage Rd N Suite -C
EMAD.
service@firesyslemswest.com
APPLICANT
CITY
Pacific
STATE
WA
ZIP
98047
FAX
PROJECT CONTACT
NAME
Matt Cadman
PRIMARY PHONE
253-951-6005
MAILING ADDRESS
206 Fronta a Rd N Suite -C
EMAIL
mattc@firesystemswest.com
(The individual to receive and
respond to all correspondence
CITY
Pacific
STATE
WA
ZIP
98047
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 authorised agent of the propertyowner. 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 s ch claim, which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arls out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the ty a part of this application.
SIGNATURE: DATE 10/22/2018
PRINT NAME: Matt Carlman
Bulletin #100 -January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application