19-103837 u 1t �ll4' APPLICATION
CITY OF 9 �Q3
Federal Way r PIT A9C 3325 8 h Avenue South+ Federal Way,WA 98003-6325
Federal ;/�/ .TV
25-1-M-7607 253-835-2609 +permitrente a, :'�'offederalww, corn
C
COMMUNf7Y D Eft WAY
,�(� R3 �''') ,/,/�� EVELOPMENT
PERMIT NUMBER /-j _ / / / 1 _ F
/ !!! SS//" 11 l TARGET DATE
SITE ADDRESS SUITE/UNIT k
1409 S 348th St Federal Way, WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 4 , 500 . 00 1 8 S a / -
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING Lf FIRE PREVENTION
NAME OF PROJECT Federal Way Crossings Bldg. D
Replace Existing Fire Alarm System.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAMEC PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS /;7
DDRESSt E-MAIL
2. to C 3 CITY LJ STATEtj ZIP
( NAME PHONE`- — --
Fire Systems West, Inc . 253-833-1248
MAILING ADDRESS E-MAIL
206 Frontage Rd N, Suite-C service@firesystemswesc Com
CONTRACTOR
CITY TE ZIP FAX
Pacific A 98047
17s-oa4 WA STATE CONTRACTO
FIRESWI055LWR'S LICENSE# 4N2-4
, EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
� � 0-6-7-77'779 19-87-000014-00-BL
NAME PRIMARY PHONE
Fire Systems West, Inc. 253-833-1248
APPLICANT MAILING ADDRESS E-MAIL
206 Frontage Rd N, Suite-C service@firesystemswestcom
//,,19.1 e:),a-- Pacific STATE
98047 FAX
NAME PRIMARY PHONE
PROJECT CONTACT Matt Carlman 253-951-6005
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 206 Frontage Rd N, Suite-C mattc@firesystemswest corn
concerning this application) pacific STATE ZIP FAX
> VVA 98047
NAME _.. - — _.-. . .._._ _.-.._..__-
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW]927095/
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 arts out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city part of this application.
SIGNATURE: DATE 812/2019
PRINT NAME: Matt Carlman
Bulletin#100—January 29,2016 Page 1 of 2 k:\handouts\Permit Application