93-101156 9�-10 i���
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT PERMIT NO.: FPS93-0012
33530 First Way South BUILDING INSPECTION - 661-4140 ISSUED: 05/19/93
Federal Way, WA 98003 BY: FLF
661-4000
SITE ADDRESS: 2450 S STAR LARE RD
PARCEL NO.: 720480-0010
PROJECT DESCRIPTION: FIRE ALARM SYSTEM FOR MARR TWAIN ELEMENTARY SCHOOL
OWNER CONTRACTOR LENDER
MARK TWAIN ELEMENTARY SCHOOL JOHN KORSMO CONSTRUCTION INC
2450 S. STAR LAKE ROAD P.O. BOX 99846
FEDERAL WAY WA 98003 TACOMA WA 98499
0100 582-6712
JOHNKCI1268E
SPRINKLERS?........:? HOOD & DUCT?.......:? FEES:
# ZONES........... 0 OTHER.....:? F[RE ALARM FEE.....* $ 240.00
FIRE ALARM SYSTEM?.:? EXTENT OF WORK...:? FIRE DEPT FEE......* $ 120.00
# ZONES........... 0
STANDPIPE?.........:?
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
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TOTAL FEES S 360.00
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 OATE � �
f ps�rmt 07/01/92 �_---------- ------- ----
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����I�!`� - S S%�2 �.�K�- �� ' � � '
r�Z � , '' PERMIT � �� .> l.3 — �� I 2 FA
M�Y 13 1993
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' - Job Address: ��L �� -J `�z�; '�,C-"�:k' �l1 G
IStrseU ICity) ISute) Rip) �Suit��1
y�Z,�c� M,�l�(=� �T4.�,��n" �L� l�lP.� raP-� 5z_k::.c
Owner: ��t,�a(, �,t;��� 5�1���: �t rt �' Tenant Name• - 1-e� c,�ati sc_ blt, � 'D���
Contractor: J�ha, �-'�t�s;u.�, C�„�s-�f��cf F ;,.�, �- ti<_ Tax Parcel #
Address: _ ��{ �( i.���2 v�:o�r�° ��t�� 5 ��, �i A��tv��4 c.,� '+ `1 k H �� G
Phon��-�� ����-� ��z Contractor License #: ��� N C T L(> �� 10 C
h � 1 ► xpiration Date:
IGrd mwt be prpented)
Owner's Address: �,�I `'r �JS l �� (}U� � � r��' `.:A`� � P one: `� `� I - D 1 OC�
Contact Person: ��,� A L� � `��J�✓��=P,v Phone: ` ��� - `� 3 , ��
PLEASE SUBMIT THREE (3) SETS OF FIRE ALARM WIRING DIAGRAMS, DE1/ICE LOCATION PLANS AND CUT
SHEETS WITH THIS APPLICATION.
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INDICATE NUMBER OF ZONES ON PANEL, INCLUDING SPRINKLER ZONES, IF APPLICABLE: � �
MAXIMUM PLAN SIZE = 24" X 3G"
., _ ;.,;. . _ . ;:.;,,. _ _. .
I CER7IFY UNDER PENAtTY OF PERJIJRY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT T�THE BEST
OF MY KNOWLEDGE AND FURTNER THAT I:AM AU7HORIZED SY THE OWNEr�OF THE iiBOVE PREMISES TO'PERFORM THE '
„ WORK FOR WHICH PERMtT APPUCATION 1S MADE. 1 FURTHER AGREE TO SAVE HARMLESS`7HE CITY OF FEOERAL WAY AS
TO ANY CLA1M (INCLUDWG COSTS,EXPEN$ES,AND ATTORNEYS'.FEES 1NCURRED 1N INVESTIGATION AND DEFENSE OF :
SUCH:CLA1M};WHICH MAY BE MADE BY ANY PERSQN,tNCLUDING THE UNDERSIGNED,AND FILED,:AGAINST THE CITY OF :
FEDERAL WAY, BUT ONLY WHERE BUCH CLAIM ARISES OUT'OF THE RELIANCE OF.SHE CITY,1NCLUDING ITS OFFICERS AND <
EMPLOYEES,IJPON THE ACCURACY'OF THEINFORMATION SUPPLIED TO THE C1TY AS A PART DF?HIS APPLICATION.
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Owner/Agent:\` _ �=,� t;- ,.. . Date: � � J �5
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O�ce Use Only�P/ease do nof write be%w this/inel
Remarks:
Department of Labor and Industries
Electrical Permit shall be posted Permit Fee (Includes Frst Zone) S30.00
at all fire alarm installations. Z� Additional Zones @ S 10.00 ea. �-1� z ���";
i ✓ ?_ �;
O Received Total Fees S
Route to: Fire Department
Approved by: Date:
c�oaet