19-104551 RECEIVED PERMIT APPLICATION
CITY OF
Federal j(Y>�/!J 2019 PERMIT CENTER+33325 86h Avenue South+Federal Way,WA 98003-6325
ay SEP 2 0 253-835-2607+ FAX 253-835-2609+permitcentenhcitvoffederalway.com
CITY OF FEDERAL WAY
- OMMUNIy ��� 0
LPERMIT NUMBER_ 1 / - J
TARGET DATE
SITE ADDRESS SUITE/UNIT
505 S. 336th St 518- 5 Flo w-
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL M
$ 2,200.00 9264800270 —_
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING'DIRE PREVENTION
NAME OF PROJECT Moffat & Nichol
Adding 3) audio/visual fire alarm notification devices
PROJECT DESCRIPTION to existing FA system.
Detailed description of work to
be included on this permit only
NAME- - -- -- PRIMARY PHONE
RH Fountain Plaza Assoc LLC n/a
PROPERTY OWNER MAILING ADDRESS E-MAIL
505 S 336th ST n/a
CITY STATE ZIP
Federal Way _WA 98003 _
NAME .._.. PHONE
Western States Fire Protection 425-881-0100
MAILING ADDRESS E-MAIL
CONTRACTOR 14690 NE 95th St Ste 101 jules.mayer@wsfp.us
CITY STATE ZIP FAX
Redmond WA 98052 425-881-303
WA STATE CONTRACTOR'S LICENSE C EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
WESTESF906P1 12 i 31 19 19-99-106476-00-BL
NAME
Mayer PRIMARY
25 429 4240
APPLICANT 14690 NE 95th St Ste 101 AILING ADDRESS
E-MAIL j lu es.mayer@wsfp.us
CITY
lRedmond STATE WA8052 _ FAX 425-881-3030
NAME
PROJECT CONTACT Jules Mayer 425-429-4240
MAILIN(The individual to receive and 14690 NE 95th St Ste 101 ESS ules.ma er wsf
respond to all correspondence $���e y @ {�
concerning this application) ° `edmond WT 298052 FAX 425-881-3030
_ _
NAME - - —- - -. ..
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE
(RCW 19.27.095)
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 certify 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.
SIGNATURE/ DATE
09/18/2019
PRINT NAM : ules Mayer
Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application