HomeMy WebLinkAbout15-100553Pr" I
1116.
CITY oF RAINED PERMIT' IPPLICATION
Federal Way
FEB 042015 C FD FAPPROVED _
PERMIT NUMBER
TARGET DATE
SITE ADDRESS SUITE/UNIT#
\( �cru\-r\ 314S—'c
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING PRE PREVENTION
NAME OF PROJECT „A U r\
PROJECT DESCRIPTION e*OW -e ' . -k\r oS P
Detailed description of work to
•
be included on this permit only
E PRIMARY PHONE
PROPERTY OWNER ..\(.\C\\f ` \K1
K 1 _ 1-V�\` LLC
MAILING DR S � v SIV E-MAIL
CITYSTAT ZIP
cedexc \ c R� -)
NAME ak aV\ �'�L\-k- i • �Q. . )5� X 3 -f°,a
LING ADDRESS f \ -nyIL
CONTRACTOR � ' jQX `� ( 11 �l l PRv)Al�1 VtIVo1 l-v
jL � k \ Y cTY STATE b L-I� X53 '- L12 .• 9k9 ”
W STATE CONT CTOR'S LICENSErt EXPIRATION DATE _ FEDERAL WAY BUSINESS LICENSE#
C ..--0;). 7 "..) / /
NAME
PRIMARY PHONE
came_ ca S C ((c\-k��r
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME,� ( i1rn� � c PRIMARY PHONEJcPROJECT CONTACT n\( -11.‘c' 6 ' US
MAILING ADDRESS
(The-indi-vidual-to-r-eceive-anc�- --_-- EMAIL
respond to all correspondence C)v\ oZ, w''
concerning this application) CITY STATE ZIP FAX
PROJECT FINANCING NAME
12WNER-FINANCED
Required value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP r� 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: l �-
DATE i� — i
I
PRINT NAME: III Q-,i cJ� --,i rn Qr
Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Pennit Application
t iiii
II 11110
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of er�rjpe of fixture to be i&talled or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNIT Vikini GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER ""'' �� FIREPLACE INSERTS HOODS(Commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORSGAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPINGWOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT $
Indicate how many of each type of fixture to be installed or relocated as part of this pro'-ct. Do not include existing fixtures to remain.
BATHTUBS(or Tub/Shower Combo) LAVS(Hand sinks) TOIL ' WATER PIPING
DISHWASHERSRAINWATER SYSTEMS U'• ALS OTHER(Describe)
DRAINS SHOWERS IACUUM BREAKERS
DRINKING FOUNTAINS SINKS(Kitchen/Utnity) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SE' R PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXIS ING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
sEcoNaFLOOR __..._.._..------._.__....__ _...---....._._—_.__—__.__..._._.....
COVERED ENTRY
GARAGE ❑ CARPORT 0
OTHER/(describe)
EXISTING PROPOSED TOTAL
Area Totals
"NEVIHOMES 010.7T4*
ESTIMATED SELLING PRICE #OF BEDROOMS
COMMERCIAL-N r W/ADDITION
Construction #of Additional Information
AREA DESCRIPTION Area Occupancy Grou Group(s))
in Square Feet Type Stories
NEW BUILDIN c /_' % ' ' 'i
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
Occupancy Construction #of Additional Information
AREA DESCRIPTION Area p y Group(s)
in Square Feet Type Stories
TOTAL BUILDINQ
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100–January 1,2013 Page 2 of 3 k:\Handouts\Permit Application
