19-105507 RECEIVED
' ► PERMIT APPLICATION
CITY OF ,., NOV 15 2019
Federal VVa PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
CITY OF FEDERAL Wqy 253-835-2607+ FAX 253-835-2609 +permitcenter(ukityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER 1 I _ ' 0 5 5 o 7 _ f ? Nit(
TARGET DATE
SITE ADDRESS S ITE/UNIT#
34001 Pacific Hwy S Federal Way, WA 98003
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 4, 500 . 00 2 ° 2 1 0 4 9 ° 5 1
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING Lf FIRE PREVENTION
NAME OF PROJECT Progressive
Relocate 2 Existing Fire Alarm Notification Devices .
PROJECT DESCRIPTION
Detailed description of work to Install New Fire Alarm Power Supply
be included on this permit only Install 7 New Fire Alarm Notification Devices.
NAME PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS
E-MAIL
CITY STATE ZIP
NAME
Fire Systems West, Inc . P`53-833-1248
MAILING ADDRESS E- L
206 Frontage Rd N, Suite-C servicebfiresystemswest.com
CONTRACTOR
CITY TE ZIP FAX
Pacifica 98047
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
FIRESWI055LW 12 / 31 / 19 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@firesystemswest.com
CITY STATE ZIP FAX
Pacific WA 98047
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.com
concerning this application) CPaSTATEZIP FAX
cific WA
98047
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 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 o the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as a pa f this application.
SIGNATURE: DATE 11/15/2019
PRINT NAME: Matt Carlman
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application