95-102741 Q 9 •-1a •)741
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS95-0051
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318 ISSUED: 10/26/95
Federal Way, WA 98003 BY: FC
661-4000
SITE ADDRESS: 32061 PACIFIC HWY S
PARCEL NO.: 150050-0110
PROJECT DESCRIPTION: FPS o ADDING FIRE ALARM
OWNER —= CONTRACTOR LENDER
MICHAELS STORES ADT SECURITY
32061 PACIFIC HWY S 611 TACOMA AVE S
FEDERAL WAY WA 98003 TACOMA WA 98402
14-7259 624-3103 272-2169
ADTSES*115BS
SPRINKLERS? •? HOOD & DUCT?.......:? FEES:
# ZONES • 0 OTHER FIRE ALARM FEE * $ 30.00
FIRE ALARM SYSTEM?.:Y EXTENT OF WORK,..:NEW BUILDING PERMIT * $ 60.00
# ZONES 0
STANDPIPE'S •7
UG FIRE SERVICE? •7
FIXED SYSTEM? •7
TOTAL FEES $ 90.00
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 � yi�' DATE
f ps_prmt 07/01/92
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RECEIVED
WIPPERMIT # FP/I) �/ ) L. a, FA
REVIEWED UNDER 1994 UEt� OCT 1 6 1995
City of I ,: d e r o I Way
FIRE ALARM PERMIT APPLICATION
Job Address:
(_?0,206/ ��//=/C #0� ,f04:-;‘,-../2,9( 47 C7J /
(Street) (City) (State) (Zip) (Suite I)
Owner: Tenant Name: / 6/2/19/:::"6f
Contractor: giorl�CT/2f r� gri-E/WTax Parcel #
Address: 6-i/ / ro/n/9 ,9o' ,2
Phone: 0271• el9l‘9 Contractor License #: //s-ss Expiration Date: / 21.-( • must be presented) liprit:r
Owner's Address:
Contact Person: a/2 y t0/T Phone: o?70? -a?/ y
r
PLEASE SUBMIT T •EE (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" x36"
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 ACCURACY •F THE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION;
/
Owner/Agent: Date: i
rOffice 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:
C0049
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