19-100477CITY OF
Federal Wary
RECEIVED
JAN 3 0 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(alcityoffederalway.com
PERMIT NUMBER--'
)1_ /00 / — 0 TARGET DATE
SITE ADDRESS
SUITE/UNIT #
501 S. 336th St
204
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL #
$ 4,900.00
9264800240 _
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING WkE PREVENTION
NAME OF PROJECT
WA State Gambling Commision
Adding 7) audio/visual fire alarm notification devices and 11) fire alarm
PROJECT DESCRIPTION
Detailed description of work to
g y addressable initiatingdevices to existing FA system.
be included on this permit only
NAME
RH Fountain Plaza Assoc LLC
PRIMARY PHONE
n/a
PROPERTY OWNER
MAILING ADDRESS
501 S 336th ST
E-MAIL
n/a
CITY
Federal WayWE
STATE
ZD'
98003
NAME
Western States Fire Protection
PHONE
425-881-0100
MAILING ADDRESS
14690 NE 95th St Ste 101
E-MAIL
'ules.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 #
19 -99 -106476 -00 -BL
NAME
PRIMARYMayer P425 429 4240
APPLICANT
MAILING ADDRESS
4690 NE 95th St Ste 101lu
E-MAIL
es.ma er@wsf .us
CITY
Redmond
STATE
WA
``jj
798052
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
Tedmond
�
298052
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 authorised 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 certgy that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised 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.
SIGNATUDATE 01/28/2019
RE:
Jules Mayer
PRINT N
Bulletin #100 —January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
- r "►
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offtxture to be installed or relocated as part of this project. Do not include existin ftxtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gaa)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existingfixtures to remain.
BATHTUBS (or Tub/Shower Combo)
LAVS (Hand Sinks(
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (kitchen/utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes gd No
❑ Yes gt No
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application