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00-105576 �F Fr NW ' Fel "` p�� lla FIRE PROTECTION SYSTEM APPLICATION Federal Way Business License number: b©g 4 ci,„..etif5--- ,,, , t121 -Joss- PARCEL ' D 3-6101'1Commercial ❑ Resid- r AL ...._': h N- ( '3 SITE LCATION �' ,� ) ��� ` Tenant/Owner T LA co Y1 - ..t/\.C... , Phone 2-5I 3-s-2-9-3%Address/City/State/Zip t -2-- u C PSA — Se) , F�'�P11 co . - Nature of Work F' r-'J P\--la rI s S e M �Project Valuation: $ dinje APPLICANT Name 5 cne)In c= E I-e'2----11^I �76 v Ii 1-el M I e 'f`©✓, <--s Address/City/St/Zip I t,6 C)9 1(b1* i -u -er E. Pa jcz i i L.)1 Contact Person M i 'E'- ' ✓`n b Phone 2 3`J. .1 69 Fax S - �}Ll 2- CONTRACTOR ' / I Company Name BQS/\-� E I-eG7`f�` r / C`'�-1 o M E I c:-/-hc,)n 1`c...c Address/City/St/Zip I 66.b 7 110 '' PV . E . Contact Person M 1 VN• -- 10\abO Phone LS'3_$y$ 6993 Fax - 1s3-017_. State L&I Contractor Registration# r`e e G I0 Exp.Date y / I I /O 2, (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 f unished 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. t / / ('-.l -66 Owner/Agent t Date d FPS APP Rums®5/19/99