19-105167 REcovir-)
PERMIT APPLICATION
CITY OF IP"lia....0" OCT 2 6 2f2/ii
Federal Way PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 4 Dermitcenter(acitvoffederalway.com
- CITY OF P:.:0FiRA'.':'.'',Y 1*..
COMMUNI Y EXEVia.i.JPMENT
PERMIT NUMBER 9 - 1 0 5 I C 7 - F P TARGET DATE N
SITE ADDRESS SUITE/UNIT F
33020 10th Ave SW Federal Way.WA 9802 BLDG BB
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL��^^ F
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$ 2800.00 Li 2 S U O - D 0 07)
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING ®FIRE PREVENTION
NAME OF PROJECT Latitude Condominiums-Fire Panel Replacement
Replacement of GE Fire Shield FS502 Fire Panel due to failure.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME Latitude Condominiums PRIMARY
PROPERTY OWNER MAILING ADDRESS E-MAIL
PO BOX 4579 conniec@asofwa.com
CITY Houston STA
X ZIP 77210
NAME,Evergreen Fire &Security PHONE53--627-7561
MAILING ADDRESS E.MAR{.
CONTRACTOR 2111 S 90th Street service@evergreenfire.com
CITY STATE ZIP FAX
Tacoma WA 98444
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE I
602036117 Lic#EVERGFA979P7 12/ 31 /18 20-12-102201-OOBL
NAME PRIMARY PHONE
Evergreen Fire&Security 253-627-3794
APPLICANT MAILING ADDRESS E-MAIL
2111 S 90th ST service@evergreenfire.com
CITY STATE ZIP FAX
Tacoma WA 98444
PROJECT CONTACT NAME PRIMARY PHONE
Amy Ogren-Bedford P 253-62561
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 2111 S 90th St service@evergreenfire.com
concerning this application) CITY STATE ZIP FAX
Tacoma WA 98444
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: 47D "tel th�qd
DATE 10/17/9019
PRINT NAME: Amy Ogren-Bedford
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercdal
BOILERS FURNACES HOT WATER TANKS(Gan
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo( LAVS(Hand Sulks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
N Yes ❑ No ❑Yes 0 No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
EMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
> C ..._. .. .. . .. „
GARAGE ❑ CARPORT 0
OTHER(de bet';;
Area Totals EXISTING PROPOSED TOTAL
"'lam LOW oplu?"'
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION
Area in Occupancy Groups) Construction #of Additional Information
Square Feet Type Stories
Niw BUILDING
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information
Square Feet Type Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJICT AREA ONLY
Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts\Permit Application