The URL can be used to link to this page

Home My WebLink About15-104843 1 41/4. • CITY OF PERMIT IIPPLICATION Federal Way RECEIVED lSEP 23 2015 PERMIT NUMBER • ` 0 4 8 .4i5_ — _ _ TARGET DATE CITY OF FEDERAL WAY CDS SITE ADDRESS SUITE/UNIT# b3 8ao R tt>41/4)Sc -- �c� A \,V PROJECT VALUATION ZONING ASSESSOR'S TAXS � �/PARCEL# � � - Q j 23c Z OO /_fBr TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING a-FIRE PREVENTION NAME OF PROJECT PCOM ev'C9_.. -eot PL41 Slew!�E V\51- it yfe \ 1-0 (Oct9 -f-r-,r ,(Ne PROJECT DESCRIPTION r Detailed description of work to p 41 Detailed \c -C1 J'-� be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL CITY STATE ZIP NAME (i RVN (_"t'r IC IN L. PHONE i - 25 1-12 klOS MAILING ADDRESS E-MAIL CONTRACTOR g'Z S Wok \,•c r, °^ S . - \ SQvc) r l.- ''o I Sot kte G rr'c.i eL- CITY STATE ZIP FAX V\ v lA eVa5)1"-1_ WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# ()(50-4EI '?)l RC- 62-i /2,0/0 NO! PRIMARY PHONE yrILOkra51�c 1��.� 5`3) 4' -1.3 61 APPLICANT MAILING ESS `AE-MAIL W C%i I {Zi'� �' .es(T 1 1)(-- E- VISC^1'l'Q.��L'4'�141�! CIT STATE ZIP e o'� i. FAX AME W'fy!* Olp PRIMARY PHONE PROJECT CONTACT Q'([�1 \4[N- 6 H L tiuu�- i43) jj f'? QA (The individual to receive and _MAILIN ADDRI.ss E-MAIL respond to all correspondence 32-5 \n1 C;C\A ✓ t 5 '`'l I 1,- C /*vet concerning this application) CITY STATE ZIP FAX V a. Wi cv4303- NAME OWNER-FINANCED PROJECT FINANCING Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the city, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to city as a part of this application. ` SIGNATURE: .,M-__.._..... DATE vG 1 f 3 /7,0 is- PRINT NAME: • 1,‘4-A.131 Bulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application ir VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(conimerc al) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT _ $ Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS(or Tub/shower combo) LAVS(Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS r SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS • I+SINKS(Kitchen/utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $Z�v0 EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? Yes EI No ❑Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE FIRST FLOOR(or Mobile Home /!y!{ - A./.1 :c.r ., c>., .,.,., ;'... �,,�:��f.,�,�rf,r.✓- ,r�,;�. ,::�;9�,li!/, i;,�� ,/,.°,n/��,..J�., COVERED ENTRY DECK / GARAGE 0 CARPORT 0 EXISTING PROPOSED TOTAL Area Totals ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information in Square Feet Type Stories r / 47-'7//'/, ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information Type in Square Feet Stories /' F :277: rl//"/"/ / %�!rF�rr „/ TENANT AREA ONLY PRrtcT t1N�Y Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application