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19-104979 RECEIVES PERMIT APPLICATION CITY OF /� 1 5 2019 PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325 Federal Way O�tT 253-835-2607+ FAX 253-835-2609 +permitcenter@cityoffederalway.com -CMNDEOPMENT PERMIT NUMBER iq - p TARGET DATE SITE ADDRESS SUITE/UNIT# 30809 1st Ave S.,Federal Way,WA 98003 PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL M $795 PO 0 7 _2 _1 _0 4_ _9— _2 _4— —4— TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING X FIRE PREVENTION NAME OF PROJECT Federal Way Medical Center Add radio communicator (AES-7707) to existing Fire Alarm Control PROJECT DESCRIPTION Panel (FACP). Detailed description of work to be included on this permit only NAME PRIMARY PHONE MB&N Wong Kent LLC (253)622-8600 PROPERTY OWNER MAILING ADDRESS E-MAIL 30809 1st Ave 8 CITY STATE ZIP Federal Way WA 98003 NAME PHONE SCSS/DBA: Ace Fire& Security (360)252-1210 MAILING ADDRESS E-MAIL CONTRACTOR 4500 3rd Ave thomas.pennington@sbdinc.com CITY STATE ZIP FAX Lacey WA 98509 (360)438-4244 WA STATE CONTRACTOR'S LICENSER EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# ALARMC*820JO 04/20/2020 - NAME PRIMARY PHONE Thomas Pennington (360)252-1210 APPLICANT MAILING ADDRESS E-MAIL 4500 3rd Ave thomas.pennington@sbdinc.com CITY STATE ZIP FAX Lacey WA 98509 (360)438-4244 NAME PRIMARY PHONE PROJECT CONTACT Thomas Pennington (360)252-1210 (The individual to receive and MAILING ADDRESS EMAIL 4500 3rd Ave thomas.pennington@sbdinc.com respond to all correspondence concerning this application) CITY STATE ZIP FAX Lacey WA 98509 (360)438-4244 PROJECT FINANCING NAME ❑ 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 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 r ,nce of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of ication. SIGNATURE: / '/d,.A. r�//i/Lid i• DATE:October 14,2019 PRINT NAME:_Thomas Pennington Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application