18-104978�a
RECEIVED
CITY 01 OCT 22 2018 PERMIT APPLICATION
CITY01Federal Way
! PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
j+,j y CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcenterfr citvoffederalway.com
COMMUN[T,YDEVELOPMENT
PERMIT NUMBER ) V _ / O - l / IT? S� _ ' ' ? TARGET DATE
SITE ADDRESS
SUITE/UNIT #
34817 Enchanted Parkway S
PROJECT VALUATION
$ 4,500.00
ZONING
ASSESSOR'S TAX/PARCEL# _
8 j o2 J' ,S
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION
NAME OF PROJECT
Federal Way Crossings Bldg. Kl —F��
t a rL
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
E -MAH,
CITY
STATE I
ZIP
#Fire Systems West, Inc.
253-833-1248
MAILING ADDRESS
206 Frontage Rd N, Suite—C
E-MAIL
service®firesystemswest.com
CONTRACTOR
CITYTE
Pacific
ZIP
98047
FAX
WA STATE CONTRACTOR'S LICENSE #
FIRESWI055LW
EXPIRATION DATE
06 30 / 19
FEDERAL WAY RUSDIESS LICENSE #
19 -87 -000014 -00 -BL
NAME
Fire Systems West, Inc.
PRIMARY PHONE
253-833-1248
MAMmG ADDRESS
206 Frontage Rd N Suite -C
E-MAIL
service@firesystemswest.com
APPLICANT
CITY
Pacific
STATE
WA
ZIP
98047
FAX
PROJECT CONTACT
NAME
Matt Carlman
PRIMARY PHONE
253-951-6005
MAILDIG ADDRESS
206 Fronta a Rd N Suite -C
E-MAIL
matte@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 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 1 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 cI arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied th city as apart of this application.
SIGNATURE: DATE 10/22/2018
PRINT NAME: Matt Ca lman
Bulletin # 100 —January 29, 2016 Page 1 of 2 k:\I-landouts\Permit Application