18-10545340k
Federal s
RECEIVED
NOV 15 2018
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcentelfskitvoffederalwav.com
PERMIT NUMBER —1 R _ /VVV""" � 5 5 -3 _ F P TARGET DATE
SITE ADDRESS
SUITE/UNIT M
2002 SW Campus Dr
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL N
$ 3,500
1 3 2 1 0 3_ 9 1 0 8
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ff FIRE PREVENTION
NAME OF PROJECT
Puerto Vallarta
Replace Existing Fire Alarm System.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
NFire Systems West, Inc.
293-833-1248
LG
servv®firesystemswest.com
�
CONTRACTORO6Front
CITY
$TATE
ZIP
FAX
Pacific
WH
98047
WA STATE CONTRACTOR'S LICENSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
FIRESWI055LW
06 30 / 19
19 -87 -000014 -00 -BL
NAME
Fire Systems West, Inc.
PRIMARY PHONE
253-833-1248
MAILING ADDRESS
206 Frontage Rd N Suite -C
E-MAIL
service@firesystemswest.com
APPLICANT
CITY
STATE
ZIP
FAX
Pacific
WA
98047
NAME
PRIMARY PHONE
PROJECT CONTACT
Matt Cadman
253-951-6005
MAILING ADDRESS
206 Fronta a Rd N Suite -C
E-MAIL
mattc@firesyslemswest.com
(The individual to receive and
respond to all correspondence
CITY STATEZIP
Pacific WA 98047
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW ] 9.27.095)
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 Ci of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defeof such cl 1, which may be made by any person, including the undersigned, and filed against the city,
nse
but only where such claitart ou f the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to tha of this application.
SIGNATURE: DATE 11/15/2018
PRINT NAME: Matt C rlman
Bulletin #100–January 29, 2016 Page I of 2 k:\Handouts\Permit Application