20-101104 RECEIVED
►, PERMIT APPLICATION
CITY OF MAR 10 2020
Federal Wa PERMIT CENTER+33325 8m Avenue South+ Federal Way,WA 98003-6325
253-835-2607+ FAX 253-835-2609+perrnitcenterrdcityoffederalway.coln
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER 09 _ 16 1 6 /// _ r p */frTARGET DATE
SITE ADDRESS SUITE/UNIT#
505 S 336TH STREET, FEDERAL WAY, WA 98003 200 & 300
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 9,086 9 2 6 4 8 0 _ 0 2 7 0
TYPE OF PERMIT 0 BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT MARY BRIDGE FW
INSTALL FIRE SIGNAL EXPANDER AND NOTIFICATION DEVICES FOR
PROJECT DESCRIPTION TENANT IMPROVEMENT
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
RH FOUNTAIN PLAZA ASSOC LLC
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME PHONE
SMITH FIRF_SYSTFMS
MAILING ADDRESS E-MAIL
CONTRACTOR 1106 54TH AVE E
CITY STATE ZIP FAX
TACOMA WA 98424 (253) 926-0726
WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M
SMITHFS861RS 12/ '10 /
NAME PRIMARY PHONE
SMITH FIRE SYSTEMS 253-248-2364
APPLICANT MAILING ADDRESS E-MAIL
1106 54TH AVE EAST SBUCHER@SMITHFIRE.COM
CITY STATE ZIP FAX
TACOMA WA 98424 253-926-0726
NAME PRIMARY PHONE
PROJECT CONTACT SARAH BUCHER 253-248-2364
(The individual to receive and MAILING ADDRESS EMAIL
respond to all correspondence 1106 54TH AVE EAST SBUCHER@SMITH FIRE.COM
concerning this application) CITY STATE ZIP FAX
TACOMA WA 98424 253-926-0726
NAME
PROJECT FINANCING El 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 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.
Sarah Bucher Digitally signed by Sarah Bucher
SIGNATURE: Date:2020.03.10 09:47:22-07'00' DATE 3/10/20
PRINT NAME: SARAH BUCHER
Bulletin#100—January 29,2016 Page 1 of 2 k:AHandouts\Permit Application