12-100918 • 411162- ! 0 d 9 $i?
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FrnOf 4IA* PERMIT SF MF CO ME PL DE ENGP�
Federal Way
COMMIINI7Y DEVELOPMEIV rSERVICES APPLICATION RECEIVED
253 83.5 2607•FAX 253 N35-2609
r.nlyO(JErlrmluny.cons fX1t
FEB 2 8 Cut
SITE ADDRESS SUITE/UNIT i
32211 11TH PLACE SOUTH CITY OF FEDERAL WAY
PROJECT VALUATION ZONING ASSESSORS TAX/PARCEL I CDS
$ 8,149 c - u I
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 111MECHANICAL
❑ DEMOLITION ❑ ENGINEERING )IRE PREVENTION
NAME OF PROJECT � n oN
(/'errant Milne/norwoturte•r Luse Num e) aW
V PA RTM E N TS
INSTALL NEW FIRE ALARM SYSTEM FOR REQUIRED R2 UPGRADE
PROJECT DESCRIPTION
Detailed descripti,)rt of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY' OWNER CREEKWOOD APARTMENTS 253-839-4460
MAILING ADDRESS E-MAIL
32205 11TH PLACE SOUTH
CITY ZIP
FEDERAL WAY STATE WA8003
NAS PHONE
LINX INTEGRATED 253-848-3036
MAILING ADDRESS E-MAIL
CONTRACTOR 11409 58TH AVE E jonathan-kAlinxnw.com
CITY STATE ZIP FAX
PUYALLUP WA 98373 253-848-0542
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE I
LINXII*927PN 10/ 15 i 12 20-00-101834-00-BL
NAME JONATHAN KARKOSKY PH253-848-3036
APP'I`- MAILING09 58TH AVE E jonathan-k@linxnw.com
CITY STATE ZIP FAX
PUYALLUP WA 98373 253-848-0542
PROJECT CONTACT NAME PHONE
(The individual 3o receive and JONATHAN KARKOSKY
respond to all on-respondence MAILING ADDRESS E-MAIL
concerning lttis application)
CITY STATE ZIP FAX
ALTERNATE CONTACT NAME: PHONE E-MAIL
PROJECT FINANCING NAME
❑ OWNER-FINANCED
Required value of$5,000 or snore
(RCW 19.2;.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
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 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: —� - DATE 02-28-12
PRINT NAME: Jif NATHAN OSKY
Bulletin#1(H)—January 1,2011 Page 1 of 3 k:AHandouts\Permit t