95-102301 9���a�3 0/
C�TY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERIVIIT PERIVIIT NO.: F'PS95�0040
33530 First Way South FIRE DEPARTMEIVT INSPECTION - 946-7318 ISSUED: 09/13/95
F�deral Way, WA 98003 BY: FC
6�1-4000
SNTE ADDRESS: 31607 P�+,CIFIC HW3C S
P�RCEL NO.: 082104-9017
PIROJECT DESCRIPTION: FPS m 1�DD (16) SPRII�TRLER HEADS TO EXISTING SYSTEMAY,)
041NER CONTRACTOR LENDER
NOAH'S NEW YORK BAGEL'S COSCO FIRE PROTECTION
31217 PACIFIC HWY S 10910 117TH PL NE
F�^�RAL WAY NA 98003 KIRKLAND 41A 98033
827-9654
COSCOFP110NM
`SPRINKLERS?........:Y HOOD & DUCT?,....,.:? FEES:
# ZONES........... 0 OTHER...... SPRINKLER FEE......* $ 54.00
FIRE ALARM SYSTEM?.:? EXTENT OF 410RK...:? BUILDING PERM[T....* $ 54.00
# ZONES..........: 0 F1NAL PLAN CHECK...* $ 35.00
�TANDPIPE?.........:?
0
lUG FIRE SERV[CE?...:?
FIXED SYSTEM?......:?
TOTAL FEES $ 143.00
INSPECT%ON RECORD
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
I �ERTIFY 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.
O�/NER OR AGENT DATE � ( / ���
fps�rmt 07/01/92
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F�E��I\!'EC3
�� G City of Federal Way ,��.� � � �995
� �'�` APPLICATION FOR BUILDING PERMI�,;�TY OF FEDERAL WAY
SUILDING DEPT.
����'���� ������ ����� ���
PLEASE PR/NT APPL/CAT/ON #: ����
SITE LOCATION Address
Tenant 1if known) Lot #
G� /f` �� O�x ���L L j Assessor's Tax #
�� t'_�
Building O ner Name �� ` � � Addres�s
�'a L% i�!� -/�/� Ci�/C� fl�l,�' �. „j%Z�' S�
City � ��} State (,���. Zip Phone
Nature of Work � l� C�����l ,,�'
� �;�?T�� G �-�c'%s r>r.�L� .`_� ��iz3��1
APPLICANT
Name (F,M,U � � n
t;C��;�� �7�- L
Address
L ` lG 7 T'f ��_ �.l�.
Cit ' State
v / >i� C il-i.�i (,:_1i-�- zip ` ' 3�
Contact Person Day Phone Other Phone Fax
S��"y� l✓%7��I��� �Z7-�� S¢ �-�"�, - � � �
j BUILDING CONTRACTOR'
Company Name r , 1
�-t-'.S��C' f I�� .�C�T�`C T�u.�/
Address ,
�� �� -- �/ � �.-
City �G.'�CLf,I.,/✓� State i.�%�-/ Zip � 1���
Contact Person ���, f� / / Fax
� V G'�( ���/F'�.�� Ph�?�-�-�/���-
Contractor's # (car d must be presented) ,- ,� Expiration Date Verified ❑ Yes ❑ No
C-(�J S�-f.� �� /QiV1Z� S�l��
ARCHIT�CT '
- -
Name
Address
City
State Z�P
Contact Person Phone Fax
LEGAL DESCRIPTION
P/ease Comp/ete Reverse Side
CD0492 IRev 4l93)
STRUCTURE xisting Use Proposed Use
Permit includes: O Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
❑ Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1 st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability C] Project Valuation S
Zoning Lot Size Existing Bldg Valuation S
L�NDER '
Name Address
City State Zip
MECHA1vICAL'CONTRACTOR'
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
___ _ __
_ _ _ __._
�LUMBTNG CONTRACTOR''
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUN'I'
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Tota[ Fixture Count
MECHANICAL IJrTIT COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Conv Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Totai Unit Count
DISCLAIMER: 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 claiml,which may be made by any perso�,including the undersigned,and filed against the City of Federal Way,
but only where such claim a e o/}°t of th reliance of�e City,including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application. // �
y �l �'j � G� C."i �
! �
Owner/Agent: y G' U� Date: � / �