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CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: F'PS93-0008
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 04/07/93
Federal Way, WA 98003 BY: JJ
661-4000
SITE ADDRESS: 30008 23RD AVE SW
PARCEL NO.: 012103-9087
PROJECT DESCRIPTION: SPRINKLERS o FOR BRUELL NSF
OWNER — CONTRACTOR — LENDER
DAVID BRUELL WASHINGTON FIRE SPRINKLER
29834 23RD AVE SW 4226 108TH AVE E
FEDERAL WAY WA 98023 PUYALLLUP WA 98372
661-2211 841-7669
WASHIFSO9603 •
SPRINKLERS' •Y HOOD & DUCT? •7 FEES:
# ZONES - 0 OTHER •'7 BUILDING PERMIT....* $ 72.00
FIRE ALARM SYSTEM?.:? EXTENT OF WORK •'
FINAL PLAN CHECK... $ 47.00
# ZONES • 0 SPRINKLER FEE * $ 59.50
STANDPIPE? •7
UG FIRE SERVICE? •7
FIXED SYSTEM? •7
TOTAL FEES $ 178.50
1
INSPECTION RECORD
•
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I CERTIFY THAT THE INFORMATIO URNISH•I'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 11 DATE Li / (_
fps_prmt 07/01/92 v 1 '
N
RECEIVED
PERMIT 4PJ 'Y 9 _(,�,>
City •
WAFEI"AL .1f
o f Federal W a y
FIRE ALARM PERMIT APPLICATION
' Job Address: L J ! Y& f'et1CY `J (04 (4g6 23
(Street) (City) (State) (Zip) (Suite r)
Owner: 1/1J.Yr- &Lill Tenant Name: 73.4lbtsC
Contractor: oh)
� _ ' „`_: prilt u,Q,7. Tax Parcel # 0(2105 90S7
Address: t Z2 0 /C�'a" t�i c T VY(��1�� lr`l �"(D�X72_
Phone: ("76 (j Contractor License #: C;`)� - /( ((O$ Expiration Date:
cr)
(Card mint be presented)
Owner's Address: ngy'0.Q , Phone: ' Y-I� 7 to
ti
Contact Person: I 0( l.o._, Thrt Mir\ Phone: ( '7 (fc---7
PLEASE SUBMIT THREE (3) SETS OF FIRE ALARM WIRING DIAGRAMS, DEVICE LOCATION PLANS AND CUT
SHEETS WITH THIS APPLICATION.
INDICATE NUMBER OF ZONES ON PANEL, INCLUDING SPRINKLER ZONES, IF APPLICABLE:
MAXIMUM PLAN SIZE = 24" x 36"
-
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
FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS OFFICERS AND
EMPLOYEES,UPON THE AC URACY OF THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
� a
Owner/Agent: Date: 3- (1
Office Use Only (Please do not write below this line)
Remarks:
Department of Labor and Industries
Electrical Permit shall be posted Permit Fee (Includes First Zone) $30.00
at all fire alarm installations. Additional Zones @ $10.00 ea.
❑ Received Total Fees $
Route to: Fire Department
Approved by: Date:
CD0491
• S