95-1027400 5--/0 a7ya
CITY OF FEDERAL WAY FIRE PROTECTION SYSTEM PERMIT
33530 First Way South FIRE DEPARTMENT INSPECTION - 946-7318
Federal Way, WA 98003
661-4000
SITE ADDRESS: 31413 PACIFIC HWY S
PARCEL NO.: 082104-9013
PROJECT DESCRIPTION: FPS o INSTALLATION OF A FIRE ALARM SYSTEM
OWNER
BLOCKBUSTER MUSIC
31413 PACIFIC HWY S
FEDERAL WAY WA 98003
77< 1,006
SPRINKLERS?........:?
# ZONES........... 0
FIRE ALARM SYSTEM?.:Y
# ZONES .......... _ 0
STANDPIPE?.........:?
UG FIRE SERVICE?...:?
FIXED SYSTEM?......:?
I CERTIFY THAT THE INFOR
HOOD & DUCT?.......:?
OTHER......
EXTENT OF WORK...:NEW
CONTRACTOR
ADT SECURITY
611 TACOMA AVE S
TACOMA WA 98402
624-3103 272-2169
ADTSES*115BS
INSPECTION RECORD
LENDER
PERMIT NO.: FPS95-0050
ISSUED: 10/26/95
BY: FC
FEES:
FIRE ALARM FEE.....* $ 30.00
BUILDING PERMIT....* $ 60.00
FIRE ALARM FEE.....* $ 10.00
BUILDING PERMIT....* $ 20.00
TOTAL FEES $ 120.00
ALL PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED.
FURNISHED BY ME IS TRUE ANZgCORRECT TO THE BEST OF MY KNOWLEDGE AND THE APPLICABLE CITY OF FEDERAL WAY REQUIREMENTS WILL BE MET.
OWNER OR AGENT DATE
fps_prmt 07/01/92
SET BACKS AND FOOTINGS
DATE __.. BY __. _ _.
OX TO POUR FOUNDATION WALLS
DATE -.---.--BY
PLUMBING GROUNDWORK
DATE _ BY _
PLUMBING ROUGH IN
DATE ------BY
WATER LINE O.K.
GAS PIPING O.K._ _
MECHANICAL INSPECTION
DATE _ __._-_-BY T __
O.K. TO ENCLOSE FRAMING
DATE___.__ ..___BY..
INSULATION
DATE _._-_-_._BY
WALL BOARD AND FIRE WALL
DATE
FINAL O.K. TO OCCUPY
DATE
[iCl]
PSD
FD 40- /1 2
REGENEC
--- T .a6%2 11-rii
Job Address:
OCT 161995
PERMIT # � ,q5 -- ac-5d FA
(Street) Icity) (State) (Zip) ISuite #1
Owner: Tenant Name: C�Sr1-i cW �C
Contractor: ' Tax Parcel #
Address: �' C0� �r Jo
Phone: Contractor License #: ���a— - IIS Expiration Date:
ICsrd must be presented)
Owner's Address:
Contact Person: 4z y /~
Phone:
Phone: Q 7?-
PLEASE SUBMIT THREE (3) SETS OF FIRE ALARM WIRING DIAGRAMS, DEVICE LOCATION PLANS AND CUT
SHEETS WITH THIS APPLICATION.
INDICATE NUMBER OF ZONES ON PANEL, INCLUDING SPRINKLER ZONES, IF APPLICABLE: _
MAXIMUM PLAN SIZE = 24" X 36"
I CERTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME 1S 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 CLAIM), WHICH MAY BE MADE BY ANY PERSON. INCLUDING THE UNDERSIGNED, AND FILED AGAINST THE CITY OF
FEDERAL WAY, BUT ONLY WHERE SUCH CLfAi A ARISES OUT OF THE RELIANCE OF THE CITY, INCLUDING ITS OFFICERS AND
EMPLOYEES, UPON THE ACCURACY OF '1XE INFORMATION SUPPLIED TO THE CITY AS A PART OF THIS APPLICATION.
Owner/Agent:
Remarks:
Department of Labor and Industries
Electrical Permit shall be posted
at all fire alarm installations.
❑ Received
Route to: Fire Department
Approved by: _ _
Date:
Use Only ft'Iaase do not write below this line)
Permit, Fee (Includes First Zone) $30.00
Additional Zones @ $10.00 as. so� uU
{q rt � t— e e
Total Fees S
Date:
CD0491