11-101716 RECED 0 - 1 0 ( 7- 1 (0
.r„of 1'`" IPERMIT SF MF CO ME DE EN
Federal Way MAY 0 5 2011
COMM1fUNIT}'DEVELOPMENT SERl7CES FEDCATIONi /1;40W-
253
-835-2607•F-qr�1� 6 1510M .
V cDs � � 5/44-11
SITE ADDRESS SUITE/UNIT N
505 S 336th St
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL S
$ 5, 500.00 9264800270 _
TYPE OF PERMIT ❑ BUILDING LIPLUMBING C7MECHANICAL
❑ DEMOLITION ❑ ENGINEERING 6 FIRE PREVENTION
NAME OF PROJECT 1 {�
(Tenant Name/Homeowner Last Name) Konica �/t i NQ L- u sl ll — �V(JJ n o
Install and relocate fire alarm devices for TI
PROJECT DESCRIPTION
Detailed description of work to
be inch tried on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
Froula Alarm Systems, Inc. 206-575-1962
MAILING ADDRESS E-MAIL
861 Industry Drive kris,Ofroulasolutions.com
CONTRACTOR
CITY STATE ZIP FAX
Tukwila WA 98188 206-575-1962
WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S
FROULAS122DS /
NAME Ult./1y citPHONE
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
PROJECT CONTACT NAME PHONE
Kristopher COnner 253-753-6660
(The individual to receive and
respond to all correspondence MAILING ADDRESS E-MAIL
concerning this application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
Tammy Hansen 206-575-1962
PROJECT FINANCING NAME
OWNER-FINANCED
Required value of$5,000 or more
(RCW I 0 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
informatioplop ied to the city as a part of this application.
SIGNATURE: i Ilt ( . 41.1_a0 L �.,, DATE II—` I
V
PRINT NAME: v-.0,....- - Ab��awil` IO
Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application