03-104786 �,
f UrY oF �� ���'�!��',L,I BUII,DING DIVLSION
� �'_�E�_ 33530 First Way South
v v �Y 0 C T 2 1 2003 Federal Way,WA 98003
(253)661-4000
Fax(253)661-4129
CITY Oi=FEDERAL WAY
FIRE PROTECTION ���'��VIT'APPLICATION
Federal Way Business License number: �3 7�y
F P S � 3 - �b� 7S(o-00
PARCEL # f� a�b �( ���/3 � Commercial ,Q Residential ❑
SITE LOCATION
TenandOwner C�� ��� P� Z z�� Phone
Address/City/State/Zip ���� � r��� "► ��v�/ � � ���' ��-�
Nature of Wor � � Project Valuation:$ ����
APPLICANT
Name�( �,���U 1 ��Y� �����
Address/City/SUZip � I� I �� � � �o'Z 1�Y1'��� (�tl A -(0 /Z%
Contact Person c d�� �/L"�nn a Phone �'S3"�2�0"�2`�C Fax 0�����l�'
CONTRACTOR
CompanyName--�C�\Y ►Cl1 ��1��'_ ��(�l�'.�.t�
Address/City/SdZip���� ��� � v� � ��� �1�� �/� �b l�y
ContactPerson ��1� �n►Ce� Phone �� 'g� -229a F� �,53' ��2'�/5G'
State L&I Contractor Registration# r� ,J �� 1' PO 1 R C F Exp.Date �����
(Card musl be presuitet�
PLEASE SUBMIT THREE(3�SETS OF DRAWINGS AND CUT SHEETS,PER NFPA STANDARDS.
MAXIMUM PLAN SHEET SIZE: 24" X 36"
DISCLAIMER:1 certify,under penalty of perjury,that the infovnation hunished by me is hue and coaect W the best of my l�owledge end fiutha that I em authoriud by the owna of tlu ebove premises W perfoan the wodc
fot wltich pertnit appficatiort is made.l fiuther agra to save hamilas the City of Federal Way u W any olam�(mcluding costs,wcpa�sa,end atWmeys'fea incuned in investigation and defense of such claim),which may be
made by any persoq including the undetsigned,and 61ed against the City ot Federay Wey bu[onty where such daim arises out of the reliance of Ne city,including its o�cas end anployea,upon the eccweiry of the
inCormation supplied to the city as a part of this application. �
Owner/Agent �-�-'c...1�1, /����Lc�.-u�,--�- Date �D�a��`�-�
FPS.APP
Revrs�S/19/99