19-100865• RECEIVED PERMIT APPLICATION
CITYOF
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FEB 2 2 2019 PERMIT CENTER + 33325 8t' Avenue South + Federal Way, WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 + permitcenter�acityoffederalway.com
CITY OF FEDERAL WAY
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PERMIT NUMBER / / _ / / ) J� /,•y .5 _ F, ic TARGET DATE
SITE ADDRESS
SUITE/UNIT #
505 S. 336th St
205/HALL
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 1
9264800270
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING W[IRE PREVENTION
NAME OF PROJECT
PEDIATRICS NORTHWEST/HALLWAY
Adding 7) audio/visual fire alarm notification devices and 11) fire alarm
PROJECT DESCRIPTION
Detailed description of work to
addressable initiating devices to existing FA system.
be included on this permit only
NAME
RH Fountain Plaza Assoc LLC
PRIMARY PHONE
n/a
PROPERTY OWNER
MAILING ADDRESS
505 S 336th ST
E-MAIL
n/a
CITY
STATE
ZIP
Federal Way
WA
98003
NAME
Western States Fire Protection
PHONE
425-881-0100
MAILING ADDRESS
14690 NE 95th St Ste 101
E-MAIL
jules.ma er@wsf .us
CONTRACTOR
CITY
Redmond
STATE
WA
ZIP
98052
FAX
425-881-303
WA STATE CONTRACTOR'S LICENSE #
WESTESF906P1
EXPIRATION DATE
12 /31 /19
FEDERAL WAY BUSINESS LICENSE #
1 19 -99 -106476 -00 -BL
NAME
Jules Mayer
PRIMARY PHONE
425-429-4240
APPLICANT
MAILING ADDRESS
14690 NE 95th St Ste 101
E-MAIL
jules.mayer@wsfp.us
CITY
Redmond
STATE
WA
18052
FAX
425-881-3030
PROJECT CONTACT
NAME
Jules Mayer
PRIMARY PHONE
425-429-4240
MAILING ADDRESS
14690 NE 95th St Ste 101
E-MAIL
jules.mayer@wsfp.
(The individual to receive and
respond to all correspondence
ClRedmond
WA
2198052
F 425-881-3030
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAILING 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 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 this application.
SIGNATURE: _DATE 2/21/2019
PRINT NAME: ules Mayer
Bulletin #100 — January 29, 2016 Page 1 of 2 k:AHandouts\Permit Application