HomeMy WebLinkAbout15-105214 t t ' firEIVED • CITY OF Alb. OCT 13 2015 PERMIT APPLICATION Federal Way CITY OF FEDERAL WAY CDS P PERMIT NUMBER 5 _ I b 5 / _ TARGET DATE SITE ADDRESS SUITE/UNIT# 1066 S 320th St Federal Way WA — 2653 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ 141,245.63 0 8 1 0 - 9 1 8 TYPE OF PERMIT ❑BUILDING ❑PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ENGINEERING RI FIRE PREVENTION NAME OF PROJECT High Point Install Underground Fire line PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER High Point 320 LLC 425-453-9551 MAILING ADDRESS E-MAIL 10900 NE 8th Street Suite#1200 CITY STATE ZIP Bellevue WA 98004 NAME PHONE _.. -....._. Lloyd Enterprises Inc 253-874-6692 MAILING ADDRESS E-MAIL CONTRACTOR PO Box 3889 jeffw@lloydenterprisesinc.com CITY STATE ZIP FAX 33'1q Federal Way WA 98063 253-838-0103 1 WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# LLOYDI*238QB Q4 / 15 /2017 20-00-102138-OOBL NAME ..... PRIMARY PHONE -. Lloyd Enterprises Inc(Jeff Washington) 253-835-6615 APPLICANT MAILING ADDRESS E-MAIL ^ G/J PO Box 3889 JeffW(a�lloydenterprisesinc.com �-/ 1 ) 11 /3 CITY STATE ZIP FAX r/1_'^l� V VFederal Way WA 98063 253-838-0103 NAME PRIMARY PHONE PROJECT CONTACT Lloyd Enterprises Inc(Jeff Washington) 253-835-6615 (The individual to receive and MAILING ADDRESS E-MAIL respond to all correspondence PO Box 3889 JeffW@Iloydenterprisesinc.com concerning this application) CITY STATE ZIP FAX Federal Way WA 98063 __ NAME _._ .. PROJECT FINANCING High Point 320 LLC I OWNER-FINANCED Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE IRCW 19.22.095) 10900 NE 8th Street Suite 1200 425-453-9551 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 the city as a part of this application. f SIGNATURE: _ DATE /L'--1. --/i PRINT NAME: Lloyd Enterprises I c(Jeff Washington Bulletin#100—January 1,2013 Page 1 of 3 k:AHandouts\Permit Application