02-105053 ... . -
II •
,,,,,..., . BUILDING DIVISION
EO RECEIVED 33530 First Way South
'a\ Ry Federal Way,WA 98003
V (253)661-4000
NOV 1 3 2002
Fax(253)661-4129
FIRE PROTECTIQ F3'_°[EM APPLICATION
Federal Way Business License number: 0-01- 10 2a(4)2-00-et.._ •
FPSOa, - /0S—°S-:
EL# 15'
n ' (OS C CQ Commercial al Residential 0
- . 00ATION
.JOwner DOL-Liq�'WISC 117 ICJ/ I LFiKCS vIL(.AGE Phone
:,s/City/State/Zip ? 70 S 0 ell' _-,'t FSE-AC_ (tm Y, W A 9c142,2
,.,:::Suc of Work h-1(;I EttZ 01)ZIM K(_t;,2 HE✓-/U PC A'1cc k'1Gt1T Get/ Project Valuation: $ v 7 J
EX IST/A/(7 Spg-1,I q-CR- S t<57--E" !\
,. ;ANT
;'s;;v z ,5PRIkt . IR-C ilk O TEC_Tfed, /Aft_
ta. --s/City/St/Zip ?M3 '/2 - S//y 7f. FcSOice Oe t(J) #E 0716 hlfr1t8cv_ , L1' . ?,g33S
C.. :,ztct Person gFTC 7 CLC-l‘)p 0 Phone Q'5 3 - 4 ( C-) Fax 62)53 -"5 .?0
Cr.,'TRACTOR
Co::; any Name i-.'R kkCi IRS: r?FoyCc-T/Cu/ /#/C-
Adr. t;ss/City/St/Zip ?tilt 4/2 - 5//"I ?f. FosD/Cit. Dr. N6) #E GIG Ni0Soz , t,JA. 9633s
Contact Person Phone Fax
State L&I Contractor Registration# - 'R l A-I F P 6 1 1 L S Exp.Date 6 • '7- t.,1
(Card must be presented)
PLEASE SUBMIT THREE(3)SETS OF DRAWINGS AND CUT SHEETS, PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" x 36"
DISCLAIMER I certify,under penalty of perjury,that the information furnished by me is true and correct to the best of my knowledge and further that I am authorized by the owner of the above premises to perform the work
for which permit application is made.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 Federay 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---- ( Date //" /2 - C'1
FvsA..
Rmsen 5/19/99