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14-1037000 CITY OF -;:k PERMIT APPLICATION Federal Way RECEIVED PERMIT NUMBER I _ _ FP JUL 2 3 2014 _ TARGET DATE r -T -17V nG PGnFRAI WAY SITE ADDRESS Woo 3 -45zo 16'M /AvE. S, FE0Er,qC- WAY wA �'SUITE/Unt PROJECT V�A�L-�UnATI�O�Nf� ZONING ASSESSOR'S TAXj/PARCEL # ' I SC1V a �= //'' L. L 4— l 4 I O U TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 2tIRE PREVENTION NAME OF PROJECT WA LM /LT LF AA - -ST©/Z-E #3-79!L 13 -1-DT-A'- 267 S l t L -P A CCp mo — PROJECT DESCRIPTIONAbb Detailed description of work to PATE Ar -EA -5 M l -E o VEY s C be included on this permit only PROPERTY OWNER NAME WA L'Y 1A ll -r S I v JC S , I N L, t PRIMARY PHONE i' A MAILING ADDRESS LIl, E-MAIL CITYSTATE tic �A/ V tai, ZIP P z/ NAME %/ M n/?/�-� 1 1 �GS� C-!!01 .11/" WV NE �y H6� 7/8 ��'i k4— MAILING ADDRESS -7 6 ,� y t r 65 'E-MAII CONTRACTOR CITYSTATi VANC-od � WA- ZIP -196 3 FAX 1J4(96) 362-59 -C WA STATE CONTRACTOR'S LICENSE # r1/ZS 5G L 9 Lz o EXPIRATION DATE 1 VEDERAL WAY BUSINESS LICENSE # z0'-13- #3,446 -©p L NAME a15 � SEN PRIMARY PHONE ?6-02 718 -9 6 0 4 - MAILING ADDRESSE-MAIL 7 2 �7 3 '/� ( � ACE PA C ob, rl? e hO 1 rPs� APPLICANT CITY NC(3vUt /L STATE wA, ZIP g9663 FAX SE?6 362 S�So NAME 9 1; PRIMARY PHONE PROJECT CONTACT vawN MAILING ADDRESS/1 / 4 M€ A s A MA (The individual to receive and respond to all correspondence CITYSTATE ZIP concerning this application) PROJECT FINANCING NAME OWNER -FINANCED Required value of $5,000 or more MAILING ADDRESS, CITY, STA E, 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 a part of thisapplication. /41� SIGNATURE: .. ��-- ' ` DATE / / 4— PRINT NAME: f6EITT Csl� E N Bulletin #100 — January 1, 2013 Page 1 of 3 k:\Handouts\Permit Application �, CeA-7 0 ill z I *i to] LETTER OF TRANSMITTAL Attention: Building Department Title: Fire Sprinkler Plans Examiner AHJ: City of Federal Way Building Department Regarding: Fire Sprinkler Submittal for Walmart Federal Way Store #3794 TI Address: 333258 th Avenue South Federal Way, Wa. 98003-6325 From: Bob Green Date: JUIy I 1, Lu 14 Subject Address 34520 16 Avenue South Federal Way, Wa. 98003 Includes: 1. 3 Sets of Shop Drawings 2. 1 Set of Product Data Sheets 3. 1 Building Permit Application 4. 1 Check for $545.53 for total fees These are submitted for your approval. Please call when ready to pick up, or mail when finished with plan review. If you have any questions, please call. Copy: to file Thank you, r, Robert D. Green, CET Bob.green@firestopco.com 360-718-8604 3203 NE 65`h Street, Ste. 2, Vancouver, WA 98663 P 360-718-8604 * F 360-718-8603 WA / FIRESCL9220H * OR / 183279 * CO / 121482