19-101883RECEIVED
CITY OF APR 19 2019
PERMIT APPLICATION
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PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
' {{,,,,,,�, 1 a �/�/ CMM OF F EDERAL WAY DEVELOPMENT OPMENT 253-835-2607 + FAX 253-835-2609 + permitcenter(a?cityoffederalway.com
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PERMIT NUMBER 1 I _ / lll/// / % / g J( 2 _
cc[���—FP TARGET DATE
SITE ADDRESS
SUITE/UNIT #
1925 SOUTH 341ST PLACE, FEDERAL WAY WA 98003
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL M
$ 1,557.00
390380-0050 _
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING IRE PREVENTION
NAME OF PROJECT
Family Life Comm. Church 2nd FI TI
Remove 2 notification appliances from existing wall to be demoed, and add 1 notification
PROJECT DESCRIPTION
Detailed description of work to
appliance in the middle of the room for the purpose of tenant improvement.
be included on this permit only
NAME
Kit's corner Business parl
PRIMARY PHONE
253-838-3275
PROPERTY OWNER
MAILING ADDRESS
E -NAIL
1925 341st PI
CITY
Federal Way
STATE
WA
ZIP
98003
NAME
Fire Systems West, Inc.
PHONE
253-833-1248
CONTRACTOR
MAILING ADDRESS
206 Frontage Rd. N., Suite C
E-MAIL
rod rigoq @firesystemswest. cc
CITY
Pacific
STATE
WA
ZIP
98047
FAX
253-735-0113
WA STATE CONTRACTOR'S LICENSE N
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE k
FIRESWI055LW
6 / 16 /2019
19 -87 -000014 -00 -BL
NAME
Rodrigo Quinteros
1T"UM18
MAILING ADDRESS
206 Frontage Rd. N., Suite C
E-MAIL
rod rigoq@firesystemswest.c
APPLICANT
CITY
Pacific
STATE TZIP
WA 1
98047
FAX
PROJECT CONTACT
NAME
Rodrigo Quinteros
PRIMARY PHONE
253-833-1248
MAILING ADDRESS
206 Frontage Rd. N., Suite C
E-MAIL
rod rigoq@firesystemswest.c
(The individual to receive and
respond to all correspondence
CITY
Pacific
STATEZIP
WA 7
98047
FAX
253-735-0113
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 cert(fy that to the best
of my knowledge, the information submitted in sup rt of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Wayr lations pert fining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not emo the own is responsibility for compliance with local, state, or federal laws regulating
construction or environmental Ia.
I further agree to hold harml s the Ci of Fede 1 Wa to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of ch clai , which a e made by any person, including the undersigned, and filed against the city,
but only where such claim ari es out of reit a of the city, including Its officers and employees, upon the accuracy of the
igfbrmation supplied to the city as a part o th cation.
SIGNATURE: - DATE 4/17/2019
PRINT NAME: Rodrigo QU teros
Bulletin #100— January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
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