20-102627-Building Permit Application-07-22-2020-V1I
CITY OF PERMIT APPLICATION
Federal Way PERMIT CENTER + 1,33), w, 5errxu Sonth + Perim rl \I',r+, t4A 1)800J Ir;1g
15.1 fi.i,5 A,07 + FAx 1;,.I K 3:, )l U'I + Iu evil rile ,;i ri nllrrlr r.il ',.« r nrr
PERMIT NUMBER
,— TARGET DATE
SITE ADDRESS
SUITE/UNIT M
(7 7 T`14 Ci` 4Fi)FFAi fir ii 1
PROJECT VALUATION
VI
TONING A88EB$OR'$ TAXJPARCEL i•
TYPE OF PERMIT
--
543(rILI)MG ❑ PIAIMIiING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINBLRING ❑ IlIRE PREVENTION
NAME OF PROJECT
` o .r
G
PROJECT DESCRIPTION
8
Detailed descnptian of work to
be included on this pennit only
NAME PRIMARY PHONE
�d � y '�u- ^Q
PROPERTY OWNER
MAILING ADDRESS
i t v ST" N vU
E-MAIL
Nkvo f
CITY STATE ZIP
A
NAME � �� � � LC
PITo E
CONTRACTOR
MAILING ADDRESS Q /�
2 E
EMA1L
CirvC V 1 �
/,j
STATE
�/�/�
ZIP
FAX FAX
WA STATE CONTRACTOR'S LICENSE /
EXPIRATION DATE
UBT 0
NAME r � ' E�
T lVC)
PIU YPHONE
Z Slt�2'
APPLICANT
MAILING ADDRESS
13 v r
E-MAIL
-rP1SL1CgrtjY C
CITY
11nn L�
STATE ZIP
FAX
PROJECT CONTACT
NAME
li tA' ,
PRIMARY PHONE
(The individual to receive and
MAILING ADDREBB
E-MAIL
respond to all correspondence
+
CITY
y,
STATE
I
ZIP
t
FAX
concerning this application)
PROJECT FINANCING
NAME
TR b
OWNER -FINANCED
11lhei! wilue I5 $:,,pDU or more
I)A W 1 09")
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorised 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 sue Iaim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied t the city as apart of this application.
SIGNATURE: DATE 7 r v
PRINT NAME: TI" �IST C9eaC).
Bulletin # 100 — 1'ehruary 19. 2020 Rige 1 of 2 k:',I kmdoul, lIle nlil Applitniion
VA wF, OF MECHANICAL WORK
MECHANICAL PERMIT
$ i 0
Indicate how m4mny of each type of
flxture to be installed or relocated as Rart of this project. Do not include existi res to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describc)
t AIR CONDITIONER
FIREPLACE INSERTS
_
}t00DSjC..—tdd1
-
BOILERS
1 FURNACES
IIOT WATER TANKS IG-1 -
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$ f0 30v 0J
Indicate how mare o each type o
re to be installed or relocated as art o this ro'ect. Da not include existing res to remain.
BATHTUBS
LAVS
Toli'm
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
oTmIR (Drscribr)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
�_ S1NKS (K,,d..jU,.Ltvl
WATER HEATERS (Ei,—j
_ ---...—
L HOSE BIBBS
SUMPS
— 1 WASHING MACHINES
p�
I l-- TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF F7 STINO IMPROVEMENTS
`� O
l�
1 V
$ —
EXISTINGIPREVIOUS USE
LOT SIZE tln Squu* Feell
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes C�'No
[-]Yes i✓NO
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
11
BASEMENT
FIRST FLOOR (or Mobile Home)
b
b
................
SECOND FLOOR
COVP,12Pa) ENTRY
DECK
NA
(;ARAGE; CAttl'(IRT ❑
1540
--__ _..._..._..-- — — - --
_-_.-..............._.._....-._.._.._.__._......, _...
OTHER (describe)
Area Totals
E7aNTING
PROP06ED
TOTAL
"'THEW HQ&MS OAFLT"
ESTIMATED SELLING PRICE. $_ ,
q OF BEDROOMS _-3
COMMERCIAL— NEW/ADDITION
AREA DESCRIPTION
Area in
$ uare Feet
Occupancy Groups)
Construction
a
B of
Stories
Additional Information
NEW BUILDING
.
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Groups}
Construction
a
8 of
Stories
Additional Information
TOTAL BUILDING
TENANT AIi.A ONLY
PRO.IacT AREA ONLY
J
Bulletin 4 100 — February 19, 2020 Page 2 of 2 k:1HalldoutslPemlit Application