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HomeMy WebLinkAbout15-103219RACEPAD ewer JUL 06 A 0 FederalV"Y CITY OF FEDERAL 47 COMMUNTTV DEVELOPMENT SERVICES CXPPLICATION SF MF CO ME EL PL DE EN FP 33325 8TH SOUTH • PO 972 9718 FEDERAL WAY, WA 98063-9710 T53 -8.95-T607• FAX 253-835?609 www. rdaalr&Ieral wa u. corn The following is required Worwtation - an incomplete application will not be accepted. Please print legibly (in inlc) or type. SITE ADDRESS 30704 8th Ave SW gmrz/UNxT # ASSESSOR'S TAR/PARCEL # 1788700315 _ _ _ _ _ _ _ LOT SIZE (sf) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (4n -h pWf r1. ,fid --Otto l PROJECT. - TYPE OF PERMIT id BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this Hermit onlu) RESIDENTIAL REROOF. REPLACE 11 SQUARES OF COMPOSITE ROOFING. REPLACE 2 SHEETS OF PLYWOOD NO STRUCTURAL CHANGES PROJECT NAME (Name of Business or Oumer Last Name) PROPERTY OWNER CONTRACTOR APPLICANT PROJECT CONTACT LENDER COSSIo NAME Ramon Cossio PRIRY PHONE ( 253 ) 946-3937 MAILING ADDRESS CITY, STATE, ZIP E-MAIL ADDRESS 30704 8th Ave SW Federal Way, WA 98023 CITY, STATE, ZIP COMPANY NAME APPLICANT NAME OFFICE PHONE Home Depot At Home Services CITY, STATE, ZIP ( 800 ) 381 - 5699 MAILING ADDRESS CITY, STATE, ZIP CELL PHONE 3600 LIND AVE SW STE150 RENTON WA 98057 _ CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 20-03-101448-00-B ( ) - CORTDAO'Pore !>f OISTMTI0N IIIJISEE6 XZPMATION DATZ E-MAIL ADDRESS HOMED"" 972RQ 02/03/2017 COMPANY NAME Northwest Permit Inc. APPLICANT NAME Naida Khan OFFICE PHONE ( 360 ) 945-2787 MAILING ADDRESS CITY, STATE, ZIP CELL PHONE 9808 31 ST AVE SE EVERETT WA 98208 - RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑ Tenant iZ Agent ❑ Other ( 888 ) 400-0383 NAME PRIMARY PHONE E-MAILADDRESS Naida Khan/ Northwest Permit 360 945-2787 naida@nwpermit.com NAME Per R 19.27.095: Lender igformatlon is required ifproject value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP /PHONE l ) - EXISTING USE Residential EXISTING ASSESSED/APPRAISED VALUE PROPOSED USE VALUE OF PROPOSED WORK $ 6326.00 SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE ISEPTICI • AREA DESCRIPTION E3USTING . FT. PROPOSED SQ. FT. TOTAL SQ. FT. BASEMENT CTAS WATER HEATERS MISC (Describe) BOILERS CEINSERTS FIRST COMPRESSORS FURNACES RANGES SECOND GAS LOG SETS REFRIG. SYSTEMS CHANGE OF USE? THIRD ❑ NO NEW ADDRESS REQUIRED? ❑ YES ❑ NO ADDITIONAL FLOORS (DESCRIBE) ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO DECK (❑ COVERED OR ❑ UNCOVERED?) ❑ YES ❑ NO GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS �rnre rsoro®�c �� rnaroam ar "NEWHOMES ONLY"' NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type offixture to be installed or relocated as part of this project Do not include existing fvrtures to remain. Value of Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS CTAS WATER HEATERS MISC (Describe) BOILERS CEINSERTS HOODS (con s—isi) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS PLUMBING BATHTUBS (or Tub/Sho— Combo) LAVS (Bethroom sinks) URINALS MISC (Descn'be) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS [ro7et) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS I cartVy under penalty of perjury that I am the property owner or authorized agent of the property owner. I cartlfy that to the beat of my knowledge, the information submitted in support of this permit application is true and correct. I cerWy 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 responsiNlity for compliance with local, state, or federal laws regulating construction or environnwntal lawn 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 cit36 including its ofjicars and employees, upon the accuracy of the information supplied to the city as a part of this appiicatiopc*? A /j l FJW,� 0)--14 dl�� FOR OFFICE USE ONLY ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑ YES ❑ NO BASIC PLAN? ❑ YES ❑ NO ZONING DESIGNATION CHANGE OF USE? ❑ YES ❑ NO NEW ADDRESS REQUIRED? ❑ YES ❑ NO UP/SEPA/SU? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO DEMO PERMIT REQUIRED? ❑ YES ❑ NO Bulletin #100 — January 1, 2008 Page 2 of 4 kkHandouts\Permit Application