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HomeMy WebLinkAbout15-103868 C2Y\C.- ECEIVED II\ II CITY OF AUG 11 2015 PERMI PPL TION ,i Federal Way Olt' �4ti CITY OF FEDERAL WAY V ItSkN% 1,114\ PERMIT NUMBER 1 5 _ — — T GET DATE SITE ADDRESS 2......64 l) ` P-- SUITE/UNIT# Licil PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# �/ e $ 6)0a) X'S 7 Z 7 5 7 5_ C / - 0 C5 0 f' TYPE OF PERMIT ' UILDING LI PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT 50/t(/�)// ?Oar �(v C ,:;) - Af fe7 43- ? c, Apt) /a . "x z5-11:-0 JuA' (rII�irc /71"Z1.) PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER /A4/co C sjpis®//Y _ MAILING ADDRESS E-MAIL 11 Li 1 \ 9 CITY STATE d ZIP 66 y NAME , PHONE C� d'ch,p4 ,+G4 (>0,--cam L 243- 4,17_ /7 Zo MAILING ADDRESSij �t E-MAIL �f CONTRACTOR / / /=t K— kJ I .�-7 ...44.47i0:\.4-e CITY STA.TFr ZIP 75 3 FAX ( A74 WA STATE NTRACTOR'S LICENS # //"_�1 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# � �57c �'7 Ai 019 / -- /ZD/7 _ NAME Y PHONE (7-� /f PRI 29,-- z ?--. 539L APPLICANT LING ADDRESS E-MAIL f' tCi- c r a 4- C - , I g 1 g c! CITY ?Y.() O -4- STATE ZIP r 5‘Vy FAX 24` /-/Z 8C NAME PRIMARY PHONE PROJECT CONTACT 2' My (The individual to receive and MAILING ADDRESS E-MAIL respond to all correspondence /�/C / .— C�7�ev7 `/ concerning this application) CITY -A / STA/EA ZIP a FAX //V [/ v NAME // PROJECT FINANCING 0 OWNER-FINANCED 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 - ance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a pa is application. SIGNATURE: DATE PRINT NAME: . 7" l5' Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application f/ (A1t VALUE OF MECHANICAL WORK IMECHANICAL>PMIT � i ) Indicate�tnany of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain_ AIR ING UNITS' r FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT A4( ,4 $ 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 SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS 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 1�0 Lv1> LUE> $ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLE YSTEM? PROPOSED FIRE SUPPRESSIOYSTEM? �j psi 4,ClOr1 , ❑Yes No 13I� Yes No (/Y �Com/+ 1 0 RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE y 3. rr,,, ;,/. ✓°-/fr 4,A; f;r f%```Xc� i,'f y r^,,/iv ! . kik.;%✓��/_ �1 ./,�V//r. ......._....._.....—._._--._—_—_..__.....__......._.. ._.._...__—__._....__._....._... FIRST FLOOR(or Mobile Home) I( 2 tflCo COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ 1?r, r / EXISTING 2;77 TOTAL Area Totals **SEW BOMBS ONLY* ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION Area Construction #of AREA DESCRIPTION Occupancy Group(s) Additional Information in Square Feet Type Stories N rL BUiLD;NW';/ ,ar; //r% f"% / r ,,; ,, ;�,, / �'! /rr.,. ,,/// ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area Construction #of AREA DESCRIPTION Occupancy Group(s) Additional Information in Square Feet Type Stories ToiAL BUILDING / ' ' ✓ r ''% r / r „/ i � r ff ,moi // TENANT AREA ONLY ,' / r h r, rte: n' d^ / i r PROJECT�ONLY." F � Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application