01-103253CtrY OF BUII.DING DngsioN
ED 33530 First Way South
"" Ry AN 1'7 Federal Way, WA 98003
(253) 661-4000
CITY OF FEDERf4L Fax (253) 661-4129
BUILDING DEpT AY
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: Lolt Zvo1
F P sol- Jo3253-00-FP
PARCEL # W d 3 r 47063 Commercial ❑ Residential
SITE LOCATION ,/Tenant/Owner %Ilu Phone
Address/City/State/Zip — ` 4'3 �j` �'�C tM� i�i 3
Nature of Wo rlr Project Valuation: $
APPLICANT
Name Cjc17 �l ✓1�-
Address/City/St/Ziv -ka
Contact Person
CONTRACTOR
f
Phone -Zc- �'7 % .� Fax
2 J 3
Company Name WA yit, , LC Address/City/St/Zip ' � � 1 ► l� 'L1 G 'lel G�i
Contact Person Li ' Phone 26-�� Atf' 7� Fax
State L & I Contractor Registration it S �S �� �" lL Exp. Date
(Card must be presented)
PLEASE SUBMIT THREE (3) SETS OF DRAWINGS AND CUT SHEETS, PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 2411 X 36"
DISCLAIMER: 1 certify, under penalty of perjury, But the information furnished by me is fix and correct to the best of my knowledge and further that I am authorized by the owner of the above premises to perform the work
for which permit application is made. I further agree to save harmless the City of Federal Way as to any claim (mcluding costs, expenses, and attorneys' fees insured in investigation and defense of such claim), which may be
made by any person, including the un"ign d, and filed against the City of Federay Way 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 a part of this application. /1
' y
Owner/Agent
FPSArr
Rms® 5/19/99
Date