96-101408 4 G-- Y 00
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS96-0021
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318 ISSUED: 05/23/96
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 33702 21ST AVE SW
PARCEL NO.: 242103-9099
PROJECT DESCRIPTION: RELOCATE SPRINKLER HEADS FOR BANK REMODEL.
= OWNER - — CONTRACTOR — LENDER
WASHINGTON MUTUAL FIRE SYSTEMS WEST
33702 - 21ST AVE SW 219 FRONTAGE RD NORTH B
FEDERAL WAY WA 98023 PACIFIC WA 98047
833-1248
. FIRESWI14081
SPRINKLERS' •7 HOOD & DUCT' 7 FEES:
# ZONES . 0 OTHER SPRINKLER FEE * $ 29.00
FIRE ALARM SYSTEM?.:? EXTENT OF WORK •7
# ZONES 0
STANDPIPE' .7
UG FIRE SERVICE' -7
FIXED SYSTEM'
TOTAL FEES $ 29.00
INSPECTION RECORD
•
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT ��G� DATE ,
y�O
fps_prmt 07/01/92 1 /
• Alta # FP510--0O - ( -
11-1 r CITY OF FEDERAL WAY ir
• til(4 221BUILDING PERMIT APPLICATION
— Please Print-
Flp�WAY
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BOX 1 TENANT NAME: WA5I- T4tJ f UTUicL
OWNER FRED ME`'EIZ 11JC_ SITE LOCATION 33702 215T AvE S'AJ
OWNER'S ADDRESS 3500 Sl= 22iD AVE CITY PO1ZTC-ASID PHONE 503) '797-350-6
DESCRIBE JOB 1Z�1..O(:.Pc-cE SPIZ►t-)KL€`Q 4 IA DS fOR BAt Ljl'z 'IR E,1-AODEL
THE PROPERTY IS OWNED BY: SINGLE/MARRIED PARTNERSHIP CORPORATION X
30X 2 CONTRACTOR'S NAME FIRE SISTERS WEST CONTRACTOR'S REG. #
Card MUST be presented
CONTRACTOR'S ADDRESS 219 F RO)JTAE RD tJ STE. 3 CITY PAGRFRC , 95047 PHONE X33-12.A
EXPIRATION DATE AUG 199(0
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING TO DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
30X 3 CONTACT PERSON J\1`'\ STGWAzt- PHONE (633-121}
BOX 4 SEWER DISTRICT WATER DISTRICT
BOX 5 ESTIMATED PROJECT COST \ I20 EXISTING BUILDING VALUATION
BOX 6 PROPERTY TAX ACCOUNT NUMBER
- LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.)
• K.C. Plat Recording#
BOX 7 BUILDING SQUARE FOOTAGE: (Existing/Proposed) 1ST FLOOR / 2ND FLOOR /
3RD FLOOR / BASEMENT / DECK / GARAGE /
BOX 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY (NO. OF UNITS = ) (K) EXISTING STRUCTURE
IX) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SQ FT
BOX 9 PLUMBING FIXTURES (including rough-ins) MECHANICAL APPLIANCES — BASIC FEE$
NO. WATERCLOSETS GAS PIPING, FEET $
BATHTUBS NO. FURNACE, ELEC. GAS $
SHOWERS GAS HOT WATER HEATER $ 1
LAVATORIES CONVERSION BURNER $
SINKS BOILER, SIZE BTU $
DISHWASHERS AIR HANDLING UNITS $
ELECTRIC HOT WATER HEATER HEAT PUMPS, SIZE $
LAUNDRY WASHER OUTLET UNIT HEATERS $
URINALS .AIR COOLING UNITS, SIZE $
DRINKING FOUNTAINS COMMERCIAL HOOD $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER $
DRAINS $
OTHER $
TOTAL FIXTURES $
TOTAL MECHANICAL FEE $
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE i
Ar" RTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
Nw.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
FEES INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM), WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
AND FILED AGAINST THE CITY OF FEDERAL WAY, 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.
OWNER/AGENT: Cl A.v..� DATE: 5-20- 96
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS96-0021
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318 ISSUED: 05/23/96
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 33702 21ST AVE SW
PARCEL NO.: 242103-9099
PROJECT DESCRIPTION: RELOCATE SPRINKLER HEADS FOR BANK REMODEL.
OWNER
HIN — CONTRACTOR LENDER =-� �_
WASGTON MUTUAL FIRE SYSTEMS WEST
33702 21ST AVE SW 219 FRONTAGE RD NORTH B
FEDERAL WAY WA 98023 PACIFIC WA 98047
833-1248
FIRESWI140B1
SPRINKLERS? •7 HOOD & DUCT?.......:? FEES:
# ZONES • 0 OTHER...,.: SPRINKLER FEE....,.* $ 29.00
FIRE ALARM SYSTEM?.:? EXTENT OF WORK •7
# ZONES • 0
STANDPIPE? •?
UG FIRE SERVICE'S .?
FIXED SYSTEM? .,
TOTAL FEES $ 29.00
INSPECTION RECORD
•
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT i [- DATE -7
.--3
fps_prmt 07/01/92 A