18-105114RECEIVED
OCT 3 0 20% PERMIT APPLICATION
CITY OF
Federal Wa MY OF FEDERAL WAY PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
Y COMMUNITY DEVELOPMENT 253-835-2607 + FAX 253-835-2609 + permitcenteacityoffederalway. corn
PERMIT NUMBER1$ _ -0 5-1 1 L' E . j
TARGET DATE III III
SITE ADDRESS
3136143rd PL SW
SUITE/UNIT S
PROJECT VALUATION
$ 9500
ZONING
ASSESSOR'S TAR/PARCEL N
7876300130_
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING X FIRE PREVENTION
NAME OF PROJECT
S o u n d v i e w Manor
PROJECT DESCRIPTION
Detailed description of work to
Install NFPA13 Multi -Purpose fire srinklers stem
be included on this permit only
NAME PRIMARY PRONE
Quadran Homes 425 748-4696
PROPERTY OWNER
MAII.ING ADDRESS 15900 SE Eastgate Way, Suite 300 caro
yn. oung@quadranthomes.com
CITY STATE ZIP
Bellevue WA [98008
NAME
PHONE
Peltram Plumbing, LLC
(253) 891-8781
MAILING ADDRESS
1929 West Valley Hwy S.
E-MAIL.
clydew@peltramplumbing.com
CONTRACTOR
CITY
Auburn
STATE
WA
ZIP
98327
FAX
(253) 891-9248
WA STATE CONTRACTOR'S LICENSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE N
UB1604295656
12/31/201)
19 -85 -000003 -00 -BL
NAME
Clyde Ward
PRIMARY PHONE
(253) 606-4966
APPLICANT
MAILING ADDRESS 1929 West Valley Hwy S.
clydew@peltramplumbing.com
CITY
Auburn
STATEZIP
WA
98327
FAX
(253) 891-9248
PROJECT CONTACT
NAME
Same as Applicant
PRIMARY PHONE
(253) 891-9248
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
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 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 apart of this app
N(��liication.ry sSIGNATURE: L 9' "'`^' �"2C.DATE 10/26/2018
PRINT NAME: Clyde Ward
Bulletin 4100 — January 29, 2016 Page 1 of 2 kAHandouts\Permit Application