19-103325 �► RECEIVED PERMIT APPLICATION
CITY OFw''
PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
Federal JUL 2019 253-835-2607+FAX 253-835-2609 +permitcenterazcityoffederalway.com
CIT''OF FEDERAL WAY
I _ I PQM N I EV 51 A
PERMIT NUMBER ��JJ JJ /l/
TARGET DATE
SITE ADDRESS SUITE/UNIT#
3939 SW 331ST STREET
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL
$ 1800.00 1421039031 _
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING Cog FIRE PREVENTION
NAME OF PROJECT ST. THERESA'S CATHOLIC CHURCH
PROJECT DESCRIPTION INSTALLATION OF NEW AES RADIO IN THE
Detailed description of work to PARISH FOR FIRE ALARM COMMUNICATION
be included on this permit only
NAME ST. THERESA'S CATHOLIC CHURCH PRIMARY PHONE
253-838-5924
PROPERTY OWNER MAILING ADDRESS E-MAIL
3939 SW 331ST STREET
CITY STATE ZIP
FEDERAL WAY WA •:I
NAME PHONE
E-SQUARED SYSTEMS LLC 253-284-3707
MAILING ADDRESS E-MAIL
CONTRACTOR PO BOX 731227 Iindseyl@e2systemsllc.00rr
CITY STATE ZIP FAX
PUYALLUP WA 98373
W�$_TILT CQPLTrCTOR.yICENSE. EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE*
�`Q ASL963 R
1/29/20 20-05-103381
NAME PRIMARY PHONE
SAME AS CONTRACTOR
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME PRIMARY PHONE
E-SQUARED SYSTEMS - LINDSEY LESLIE 253-284-3707
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence PO BOX 731227 lindseyl@e2systemslIc.con-
concerning this application) CITYPUYALLUP STATEZIP
Z�98373 FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCEP
When value is$5,000 or more i MAILING ADDRESS,CITY,STATE,ZIP PHONY
(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 reli• e of the city, including its officers and employees, upon the accuracy of the
information supplied to e city as a part of this • ••lication. /er.74c"SIGNATURE: �/ / DATE / 7
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