19-100829CITY OF
Federal Way
RECEIVED
FEB 21 2019
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 + permitcenter(a)citvoffederalway.com
PERMIT NUMBER 9 _ f v 0 � 9 _ jj
- � F � TARGET DATE 7-15-19 �//'
SITE ADDRESS G . 91-7
SUITE/UNIT 8
MPacific Highway South Federal Wa WA 98033
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL •
$ DAS $17,089
C
Q -4- -2— -1- A_ -A- - - 2 Q -3— -1-
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING IXFIRE PREVENTION
NAME OF PROJECT
StorQuest Federal Way
PROJECT DESCRIPTION
Emergency Responder Distributed Antenna System
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
William Warren Group Inc
MAILING ADDRESSe/
al2
E-MAIL
Pacific HighwU outh
CITY
.Fp,deral AU
STATE I
WA
ZIP
98033
NAME
Clearline Engineerin2
PHONE
206.47 .4171
MAILING ADDRESS
9922 E Montgomery Ave Suite 20 Clamp
E-MAIL
@clearlineengineering.com
CONTRACTOR
CITY
Spokane Valley
STATE
ZIP
FAX
WA
99206
WA STATE CONTRACTOR'S LICENSE /
EXPIRATION DATE
11 15 X2019
FEDERAL WAY BUSINESS LICENSE 3
**A lied**
NAME
Chris Lamp
PRDSARY PHONE
206.476.4171
APPLICANT
MAILING ADDRESS
9922 E Montgomea Ave Suite 20 clam
E-MAIL
clearlineen ineerin .com
CITY
Spokane Valley
STATE
WA
ZIP
99206
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
Cbris T,amp
206.476.4171
MAILING ADDRESS
9922 F Montgomeiz4 Ave,. uite 0 clamp
E-MAIL
@clearlineengineering.com
(The individual to receive and
respond to all correspondence
CITY STATE
Spokane Valley I WA
ZIP
199206
FAX
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MADdNG 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 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 clainq, 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 a part of this application.
SIGNATURE: DATE 2,15.19
PRINT NAME: &=
mp
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application