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� BDIIDING DIVLSTON
ED 33530 First Way South
�� �/ �C� 1 � 2�02 Fedcral Way,WA 98003
(253)661-4000
c:F DERAL V1IA" Fax(253)661-4129
-- DcPT
FIRE PROTECTION SYSTEM APPLICATION �� �7�
Federal Way Business License number: ��7/y
F P S DZ -I�f��f-�-�
PARCEL# -f� ���`� ' `%v� � Commercial �, Residential ❑
SITE LOCATION
TenandOwner ������� �. �p�:'� ,- t T Phone
Address/City/State/Zip Z;2�� ���r.�, i� ;w . S 1-��,�,�r� �� ,� �.5> >���rL�y�vv.�..'� I����
Nature of Work �.�_�r3z `r G� ,i� c�� ;����,`.�h� �:G_�C- •-h� �,-�J« t Project Valuation:$ !C1j�_c�o• ���
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APPLICANT
Name 1>,_�a�ci� I--r�- t�r t�•� ����.� T`
Address/City/StlZip-�`�o`� '�o�L-. 4��--`- �- , �c. � � ,v ,. , � v'\ �-i ��{a ti
Contact Person ��4��� \-�^� «•-- Phone �•=�?-`��)t„ J.�`?t! F� �i�,r l� l JU
CONTRACTOR
Company Name 1�;-�r-���k i-�� +���.�,�-�.,.., ��ti�
Address/City/St/Zip :�'�cs Tl '`� c`��' ✓�-� 1- ��c �.!r"1 T��r'�,1 `(
Contact Person ���'�� c-,�.� � -.- Phone �)�= `z�(� ��9 C_� F� _ �/.�� C, I 1 Z�
State L&I Contractor Registration# ���� '� �< <�a`<<i � �\ Exp.Date ���-����`!
(Gud murt be pruentt�
PLEASE SUBMIT THREE(3�SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMITM PLAN SHEET SI7.E: 24" X 36"
DISCLAIh7ER:t cctity,wda penalty of perjury,that ihe information fumished by me is tnu�nd co¢ect to tLe best of my Irnowledge and CuAha that 1 un autha'ved by the owarr of the obove pranises to putortn the wock
Coc which pumit appfication is made.I fiuther agree to save harrt�as tfie City of Fedenl Way ts W any clartn(mch�ding costs,e�enses,and atfomeys'fas mcuned in investigation�nd de[rnse of such elaim),which may be
made by eny�.�erson,including the undeesigned,end filed agau�st the City ot Federay Way but only whae such claim arises out of the rcliance otthe ciry,including its oH'iars and�ptoyxs,tyron the ecewacy oCthe
infoemaUon supp6ed tn Ihe city as a paR of this application.
Owner/Agent- �_���. Cv�-. �����c��u-��— Date /�`�Y�v�-
F i�S.MPP
Rev�sm 5/19/99