02-100907 RECEIVED -
- FEB 2 8 2002 , B�IN�n�oN
`� '� 33530 First Way South
�� CITY OF FEDERAL WAY Federal Way,WA 98003
BUILDING DEPT. (253)661-4000
Fax(253)661-4129
FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: �
F P S�2�/Jv9G���v-F'P
PARCEL# 7�� rSI � ��ZO
Commercial� Residential ❑
SITE LOCATION
Tenant/Owner--Sr ��A.��/ /�O S/�/%��. Phone
Address/City/State/Zip—��/-$/S 9 � f�1�< <i al/i�
Nature of Work ��-`w �it9BdG,9�o f �,�L N;e y/ Project Valuation:�l�D_ 0'�B. ��
/�i�.a/i�o/s/ — Fi,� "� �.e/N,C' F��
APPLICANT'
Name_/���!�T �/•�� /�.�0 l L�G %/Q.t/
i
Address/City/St/Zip 270 ? 7� ?L .q�/� �'/�.5� is'lCO�iO . G✓� pU�Z¢
Contact Person ��� �/��'� Phone �ZG'�Z Z 9� F� 9 Z Z' 6� s v
CO NTRACTO R
Company Name /�/9 i,� /0 T /�/.•�� /�.�d ��"G 'r D �/ -�`
Address/City/St/Zip
Contact Person ` ��f�'` Phone 92�'ZZ g V F� 9 Z Z� �i �s t�
State L&I Contractor Registration# �����F/'�0 ��C� Exp.Date
(Card must be prestntet�
PLEASE SUBMIT THREE(3�SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" X 36"
DISCI,AIMER I'ceitify,�mder penalty u[peijury.tfut the info�matiqi Gunished by me is hve a�d cmrect to t6e bat of my Imowledge end 6atl�a thet I am authori�ed by the owna of the above premises W pafoim the wock
Cor which pamit appGption is made.l fu[thet agree W save hazmlas the City of Fedaat Way u to sny claim(mduding cosh,expenses,and attomeys'fea incucred'v�invatigntion and defaue o[such claim ahich ma be
made b an � Y
Y Y Pu�M�duding fhe undusign and filed against the City of Fedetay Way but whem such claim uius out of the reliance of We dty,including its oBiars end employea,upon the accwacy of the
ntoanation suppfied to the city as e part of ' apptication.
Owner/Agent �;/ � Date �Z ��
FPSAPP
Revism S/19/99 �