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SITE LOCATION <br />CITY OF TUKWILA <br />FIRE MARSHAL'S OFFICE <br />206-575-4407 <br />FIRE PROTECTION SYSTEMS PERMIT APPLICATION <br />Applications and plans must be complete in order to be accepted for plan review. <br />**PLEASE PRINT** <br />King Co. Assessor's Tax No.C' M Cf) l7 <br />Site Address: (r2 6vinrkt plJ, Suite Number: Floor: 42 <br />Tenant Name: 4_Ur - e7,- <br />New Tenant? ❑ - Yes- No <br />Property Owner's Name: et`(--cLt ,,3 c4 Ct-4-e: <br />Mailing Address: 5Qo�, r )� `:�(�(�� �v(� . 11�� i-� 1!'eiac,k t CA `-' 2(Q(( l <br />City State Zip <br />CONTACT PERSON -if there are questions about the submittal. <br />Name714P eXt)(CirkitiTAVN Day Telephone: Pli)1Q —?M(q <br />Company Name: Cku.CtX ktDXx t 1 � x l *13 y kern <br />Mailing Address: VII -k7) L4 !`\'/e �'5 6ec Q v C bt4 <br />City State Zip <br />E-mail AddressAVOYCtXt,DV1/4.Z ( thj' Ltitt Onvn (CrFax Number: <br />Cdntractor's City of Tukwila _ ¢ <br />NICET III number: Business License number: .. C `? - <br />Total number of new/relocated devices or sprinkler heads: _ . <br />Valuation of Project (contractor's bid price): $ <br />Scope of Work (please provide detailed information): e ci\nv(QYl\-k-- <br />tryvre tN , DUVAL C2)dev(r-e. <br />PERMIT APPLICATION NOTES <br />Value of Construction — In all cases, a value of construction amount should be entered by the applicant. This figure will be <br />reviewed and is subject to possible revision by the Fire Marshal to comply with current fee schedules. <br />Expiration of Plan Review -Every permit issued shall become invalid unless the work on the site authorized by such permit <br />is commenced within 180 days after its issuance, or if the work authorized on the site by such permit is suspended or <br />abandoned for a period of 180 days after the time the work is commenced. The Fire Marshal is authorized to grant, in <br />writing, one or more extensions of time, for periods not more than 180 days each. The extension shall be requested in writing <br />and justifiable cause demonstrated. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE <br />UNDER PENALTY OF PERJURY BY THE LAWS OF THE STATE OR WASHINGTON, AND I AM AUTHORIZED TO APPLY <br />FOR THIS PERMIT. <br />BUILDING OWNER OR AUTHORIZED AGENT: <br />Signature'C <br />Print Name:, t )PJ \(P cvx� �t <br />Plan Permit App.doc 8t22/14 TFD FP Form 8 <br />Date: t tDI <br />Day Telephone: Pep) CPR) -"CJD <br />