98-101553 FI RE PROTEGTION SYSTEM PERM 9 g�JD �5�3
CITY OF FEDERAL WAY IT PERMIT NO.: FPS98�0020
33530 First Way South FIRE DEPARTMENT INSPECTION - 253-946-7318 ISSUED: 05/14/98
Federal Way, WA 98003 BY: FC2
253-661-4000
SITE ADDRESS: 34515 9TH P,VE S
PARCEL NO.: 750451�0050
PROJECT DESCRIPTION: INSTALLING NEW 1 ZONE ALARM SYSTEM.
OWNER CONTRACTOR LENDER
DIGESTIVE HEALTH SERVICES MASTER PROTECTION CORP
34515 9TH AVE S 505 PUYALLUP AVE
FEDERAI WAY WA 98003 TACOMA WA 98421
253/572-8204 253-383-3804
MASTEPC0770S
SPRINKLERS?........:? HOOD & DUCT?.......:? fEES:
# ZONES..........: 0 OTHER.....: FPS PRMT ISSUANCE. S 20.00
fIRE ALARM SYSTEM?.:Y EXTENT OF NORK...:? FIRE ALARM FEE....m'" $ 30v00
# ZONES........... 1
STANDPIPE?.........:?
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
TOTAL FEES S 50v00
INSPECTION RECORD
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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 KIVOWLEDGE AND THE APPIICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT _ _���. C/�'j�k-�'+�(� DATE �/�N�CI�
fps�rmt 07/07/92 �
• CRYOF G BUILDINGDIVLSION
� 33530 First Way South
� Federal Way,WA 98003
�� Ay (206)661-4000
Fax(206)661-4129
� 1 ' : PERMIT# C �Sq O' �U C,�
��� � FIRE ALARM PERMIT APPLICATION
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Job Address: 3�I S�S ��" A✓�- .S . � �e�le��l �„/��� �,�.r� �l,jc�3
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Ownet: A�� e�t v�„/-e /�12���`c a< <C'.�t f er ��S C���i�'e fJr�/f'l� J�� c.���r`• f
Tenant Name:� J �
Contractor:_ �''�a��f-e r ���e�-f�..-� C�.�v�k ���� Tax Parcel#
Address: 5�--� �"y�IluP p,�r i�,<..� ti � �tiwl `�ByZ /
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Phone: �z�g) 3 k 3 �3&��� Contractor License#: r`'�As'T E P`P�?'�-� Expiration Date: ����"�y��
(eara mugc tx presented)
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Owner's Address: I y o! S vc•,��^ q,,< , •1�+;fe 6 7�i � Phone: ! 2�j j Z 7 2 �/�7
Contact Person: --��-�TH 7 �2-�"F �- ��w,S Phone: (�SS) "��7
( 2s�) 3�s - 33-vy
PIEASE S[JBMIT TH12EE S'E'i'S OF�RE ALARM WIRING DIAGRAMS�DEVICE IACATION PLANS�
AND CUT SHEETS WTi'H THLS APPLICATION.
INDICATE NUMBER OF ZONES ON PANEI,�INCLUDING SPRINKLER ZONES�IF APPLiCABLE: r
Maxn�tu�t P�v SrzE=24"x 36" �
.
I certify under penalty of perjury that the infotmation fumished by me is true and cornct to the best of my knowledge and further that I am
authorized by the owner of the above premises to perfotm the work for which permit applica6on is made. i further agree to save harmless
the city of federal way as to any claim(including costs,expenses,and attomeys'fees incurred in inveskigation 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 of the information supplied to the city as a part of this
' application.
` ���Owner/Agent: Date: c
Office Use Only(P(ease do not write below this line)
Remarks:
City of Federal Way Electrical
Permit shall be posted at all Pecmit Fee(Includes Fitst Zone) 530.00
fire alann installations. Additional Zones @ 510.00 ea
���g f� 520.00
❑ Received Total Fees $
Route to: Fire Depaztment
Approved by: Date:
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