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Home My WebLink About15-103631RI§EIVED `,�oF 0 PERMIT PPLICATION Federal Way JUL 2 3 2015 CITY OF FEDERAL WAY PERMIT NUMBER J— I S () – 0 L u TARGET DATE � Z � � ✓ SITE ADDRESS SUITE/UNIT M 27203 Pacific Hwy South; Federal Way, WA 98003 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL M $ 45,000.00 BC (Community 3322049055 Business) TYPE OF PERMIT X❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT $26931 T -MOBILE - SE04020D - REDONDO (3) panels for (3) new panels; Adding (3) FRLBs. FINAL CONFIGURATION of: (6) panels, (12) Coax Cables, (1) Hybrid Cable, (3) FRLBs, (3) FRIGs, (2) PROJECT DESCRIPTION FXFBs 6 Di lexers 6 TMAs 1 COVP. Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER CHAMBERLAIN PROPERTIES MAILING ADDRESS E-MAIL 27203 Pacific Hwy South CITY STATE ZIP Federal Way WA 98003 NAME PHONE TBD MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE M EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE M NAME PRIMARY PHONE T -MOBILE / CROWN CASTLE 206-336-2867 MAILING ADDRESS E-MAIL APPLICANT 1505 Westlake Avenue North; Ste 800 Andi.Spencer.Contractor(a)crownc astle.com CITY STATE ZIP FAX SeattleWA 98109 NAME PRIMARY PHONE Andi Spencer on behalf of Crown Castle 206-336-2867 PROJECT CONTACT MAILING ADDRESS E-MAIL (The individual to receive and 1505 Westlake Avenue North; Ste 800 Andi.Spencer.Contractoroacrownc respond to all correspondence concerning this application) astle.com CITY STATE CITY STATE Seattle WA Seattle WA PROJECQ FINANCING t Required value of $5,000 or more NAME T -Mobile ❑ OWNER -FINANCED Bulletin #100 — January 1, 2013 Pagel of 3 k:AHandouts\Permit Application **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PR03ECT FLOOR AREAS FLOOR EXISTING SQ. FT. PROPOSED SQ. FT. TOTAL BASEMENT BUILDING SHELL ONLY? ❑ YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO FIRST NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO SECOND THIRD FOURTH OTHER FLOORS (DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: AIR HANDLING UNIT(S) BBQ(S) BOILER(S) COMPRESSOR(S) DUCT(S) BATHTUB(S) DISHWASHER(S) DRINKING FOUNTAIN(S) GAS PIPE OUTLET(S) INTERCEPTOR(S) ■ `FIXTURES Indicate number of each type of fixture MECHANICAL EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S) FAN(S) HOOD(S) WOODSTOVE(S) FIREPLACE INSERT(S) RANGE(S) MISC. ( ) FURNACE(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS PLUMBING LAVATORY(S) URINAL(S) WATER HEATER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS SHOWER(S) WASH MACHINE OUTLET SINK(S) WATER CLOSET(S) MISC. ( ) SUMP(S) '%TCCI ATMFR /CTPNATURF RLC I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way, but only where such claim ises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supe city apart of this application. pli d NAME/TITLE: ca,SJ < DATE: Q ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR FOR OFFICE USE ONLY: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO COMMI 1NiTY nFVF1 OPMENT SERVICES • 33530 FIRST WAY SOUTH • P.O. BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 2S3-661-4129 r M` CITY, STATE, ZIP PHONE 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: Art�r!� err 6aiGcz�l� B�( �ee�vsL C DATE 07/15/2015 Bulletin #100 —January 1, 2013 Page 2 of 3 k:AHandouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each type offtcture to be installed or relocated as part of this project. Do not include existingftxtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commerow) BOILERS FURNACES HOT WATER TANKS (Gas( COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR VALUE OF PLUMBING WORK PLUMBING PERMIT FOR OFFICE USE BASEMENT AREA DESCRIPTION EXISTING/PREVIOUS USE LOT SIZE (In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? Indicate how many of each type o re to be installed or relocated as part of this project. Do not include exist' res to remain. BATHTUBS (or Tub/Shower combo( LAVS (Hand sinks( TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DECK DRINKING FOUNTAINS SINKS (Kitchen/Utility( WATER HEATERS (Electric( .......................... _......................................... __.._...�......_. HOSE BIBBS SUMPS WASHING MACHINES TOTAL FDMURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS FOR OFFICE USE BASEMENT AREA DESCRIPTION EXISTING/PREVIOUS USE LOT SIZE (In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? in Square Feet Yes ❑ No ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT AREA DESCRIPTION Occupancy Group(s) FIRST FLOOR (or Mobile Home) Additional Information in Square Feet SECOND FLOOR Stories NEW BUILDING COVERED ENTRY ADDITION DECK .......................... _......................................... __.._...�......_. GARAGE ❑ CARPORT ❑ OTHER (describe) Area ......................... -.................................................. _... __... _.......... Area Totals EXISTING PROPOSED TOTAL -------------_._. _.. ................. _.. *'HEW HOMES ONLY** ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS COMMERCIAL — NEW/ADDITION Area Construction # of AREA DESCRIPTION Occupancy Group(s) Additional Information in Square Feet Type Stories NEW BUILDING ADDITION COMMERCIAL — REMODEUTENANT IMPROVEMENTS Area Construction # of AREA DESCRIPTION Occupancy Group(s) Additional Information in Square Feet Type Stories 100 ft Cell Tower TOTAL BUILDING Monopole Existing TENANT AREA ONLY 233 sq ft Lease Area PROJECT AREA ONLY Lease Area Existing Bulletin #100 - January 1, 2013 Page 3 of 3 k:\Iiandouts\Permit Application