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HomeMy WebLinkAbout15-106304 RECEII► • CITY p# DEC 14 2015 PERMIT APPLICATION Federal Way_ OF FEDERAL WAY CDS /''� PERMIT NUMBER / S _ / 0 '� O y_ Y p TARGET DATE SITE ADDRESSSUITE/UNIT# 39.„5-0 S'd3YJc 4r)4- �51��/7/3_ " /-c-de,-4/ l / �/� 62e9d%PARCEL# PROJECT VALUATION I./ZONING ASSESSOR'S9TAX/PARCEL $ 4, 6.-7 7Z z Z. 1 a 4 - 1 a 4 o TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 4 FIRE PREVENTION NAME OF PROJECT —rES pZ T PROJECT DESCRIPTION ADD * �c-�-1' SP>zt���V-S w ` Detailed description of work to L-0LA-TLpi.\J. be included on this permit only PROPERTY OWNER NAME PRIMARY PHONE f-\I PrN‘ I l a 4-4 f' 6/ MAIIdNK6-ADDRESS )t))( E-MAIL CITY /` 4-1 STATE ZIP at .S6 CA g2-0LB NAME ✓4-1�euczt--ur, N 4 PHONE '�� MAILING ADDRESS E-MAIL CONTRACTOR b5-S- 5o �Co CITY STATE ZIP ^ 3 FAX WA STATE CONTRACTOR'S LICENSE# /V,KIL�'- EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# AV-C-4cl Z1 l iZ 31 / 15 NAME PRIMARY PHONE 3C-6etEsigastr— APPLICANT MAILING ADDRESS E-MAIL L CITY STATE ZIP FAX PROJECT CONTACT NAME W ��t S PRIMARY PHONE (The individual to receive and MAILING ADDRESS EMAIL respond to all correspondence ✓F"v�� concerning this application) CITY STATE ZIP FAX 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 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. ` SIGNATURE: DATE Z - I0 - 5 PRINT NAME: Sir 1 Beal- Bulletin erBulletin#100-January 1,2013 Page 1 of 3 k:\Handouts\Permit Application • • r 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 FANSGAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) BOILERS FURNACESHOT WATER TANKS(sae) COMPRESSORS GAS LOG SETSREFRIGERATION 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) - TOILETSWATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALSOTHER(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 $ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? *Yes❑ No ❑Yes 0 No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) _._._..__ _._.--.-•--- SECOND FLOOR COVERED ENTRY -- GARAGE ❑ CARPORT 0 OTHER(describe) EXISTING PROPOSED TOTAL Area Totals 4**NEW HOMES ONLr , ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION AreaConstruction #of Additional Information AREA DESCRIPTION Occupancy Group(s) a Stories in Square Feet �P NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area Occupancy Group(s) Construction Stories Additional Information AREA DESCRIPTION is Square Feet TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application