00-103936 , ,.
pTY oF � BUIIDING DIVLSION
• E� � 33530 First Way South
"" Ay ��,��,�,p�� Federal Way,WA 98003
���� �-r (253)661�000
�"`� Fax(253)661-4129
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FIRE PROTECTION SYSTEM APPLICATION
Federal Way Business License number: . • v-
FPS�- �
PARCEL # � �" �� J ���� Commercial � Residential ❑
SITE LOCATION
Tenant/Owner ��` �'�/ ,�T�� �/ Phone
Address/City/State/Zip � �J l -��'v ����G'S p/�'
Natureof Work �r��l�"LL ��� 5�����'��`�' ProjectValuation: $ 1���%
APPLICANT _
'� �'7t" l ���
Nam
Address/City/SdZip �vl� �� " � —
Contact Person�����C�� Phone 2"�" T� �J 7v Fa�c � 7 ���
CONTRACTOR �
Company Name�� �l r �� ���V��1cs l�—
Address/City/St/Zip ����� � �" S� -�� l�
Contact Person �/�� !`� `�C� Phone ?-� 7� �,��d Fa�c
State L&I Contractor Registration# � r r�� ����Q L Exp.Date �2^�'OCJ
(Card must be presurte�
,
PLEASE SUBMIT THREE�3�SETS OF DRAWINGS AND CUT SHEETS�PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" X 36"
DISCLAIMER:I catiCy,under penalty of perjury,that the info�metion Cumished by me is true and carect to t6e best of my knowledge and fiutha that I am authoriud by the owna of the above prea�isea to perfoicn the wock
for which peanit appficati ' made.I CuAher agree W save hazmlas the City of Federal Way as to any claun(mcluding costs,eacpenses,and attomeys'fxs incu�red in invatigation and detense of such claim�wltich may be
made by any pe�soq in the unde�signed,end filed egeinst the City of Federay Way but only whae such claim arises out of the reliance otthe city,including its offiars and employees,upon the ecewacy oCthe
�f'onnation suppGed tfie ty as a pazt of this epp' tion. �
Owner/Agent Date �^�/ —v C
Frs a�
Rev�sry 5/19/99