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20-102983-Shablevskiy Permit Application-08-04-2020-V1am` CITY OF y Federal Way PERMIT NUMBER 2 0 PERMIT APPLICATION PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com - 1 0 2 9 8 3 - _ _ TARGET DATE 08/01 /2020 SITE ADDRESS X X S (A� 35 4 19BU ITE/UNIT M PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL %°�� D �O n V � � O _� ' � - O V TYPE OF PERMIT ® BUILDING El PLUMBING ❑MECHANICAL I] DEMOLITION ❑ENGINEERING El FIRE PREVENTION NAME OF PROJECT S NL v—i Q"-LLZCe_ PROJECT DESCRIPTION Detailed description of work to uj 4ij D kn f be included on this permit only NAME 1!$ PRIMARY PHONE 53 —Z —S 79 PROPERTY OWNER M GI G DRESS �� ' E-MAIL C STATE Wh ZIP 2 Q + , J NAME PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STAT ZIP FAX ' STATE CONTRACTOR'SLL_ C� lJ V EXPIRATION lL�, TE UBI t) 3 -- P,l y 7 cv g NAM n 6 '� PRIMARY PHONE o Q 253 -2 � `R O MAILING RESS yl E-MAIL APPLICANT CI V V Xf4- Tg� ZIP �� FAX qwlai! • Cow PROJECT CONTACT NA w, shkb I IL I 253 P2N K — I O MAILI ADDRESS ir' V E-MAIL (The individual to receive and respond to all correspondence /AV��+ CI ^^ STATE Yr11 ZIP ^� � FAX Q � concerning this application) Y • � (/� J PROJECT FINANCING NAME CK OWNER -FINANCED When value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS, 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: �ff1 Sl.—I DATE l/ uz PRINT NAME: a 1 Bulletin # 100 —February 19, 2020 Page 1 of 2 k:\Ilandouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each typo AIR HANDLING UNITS AIR CONDITIONER BOILERS COMPRESSORS DUCTING PLUMBING PERMIT Indicate how many of each typo BATHTUBS (or T b/Sho ar combo) DISHWASHERS DRAINS DRINKING FOUNTAINS HOSE BIBBS 'f xture to be installed or relocated FANS FIREPLACE INSERTS FURNACES GAS LOG SETS GAS PIPING i GAS PIPE OUTLETS HOODS (Commercial) HOT WATER TANKS (Gas) REFRIGERATION SYST WOODSTOVES re to be installed or relocated as art of this project. Do not i LAVS (Mend Sinks) TOILETS RAINWATER SYSTEMS URINALS SHOWERS VACUUM BREAKERS 2) SINKS pcimnen/utairy) WATER HEATERS (Ei-tric) SUMPS WASHING MACHINES OTHER (Describe) VALUE OF PLUMBING WORK nc lude emsti res to remain. WATER PIPING OTHER (Describe) =TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF AZZS77RG IMPROVEMENTS w-e�p,�A v�cn $ ti Lq EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? \VLCAW\�— ( o j/ —1 � r „- v 5 r� ❑ Yes)< No ❑ Yes ; <No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR (or Mobile Home) III -ID 11 I ZO SECOND FLOOR ...__....... __..___ COVEREM 1?NTRY t DECK GARAGE [A CARPORT ❑ y OTHER (describe)'( Area Totals ex[srnro PRoroeau T♦11'AL �-�. ��-�— **JaworlV'LY** ESTIMATED SELLING PRICE $ V L' # OF BEDROOMS COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information 8 uare Feet Tye Stories NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information Square Feet a Stories TOTAL. BUILDING TENANT AREA ONLY PROJECT Al1l;A ONLY i i Bulletin # 100 — February 19, 2020 Page 2 of 2 k:\I-Iandouts\Permit Application GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF AZZS77RG IMPROVEMENTS w-e�p,�A v�cn $ ti Lq EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? \VLCAW\�— ( o j/ —1 � r „- v 5 r� ❑ Yes)< No ❑ Yes ; <No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR (or Mobile Home) III -ID 11 I ZO SECOND FLOOR ...__....... __..___ COVEREM 1?NTRY t DECK GARAGE [A CARPORT ❑ y OTHER (describe)'( Area Totals ex[srnro PRoroeau T♦11'AL �-�. ��-�— **JaworlV'LY** ESTIMATED SELLING PRICE $ V L' # OF BEDROOMS COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information 8 uare Feet Tye Stories NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information Square Feet a Stories TOTAL. BUILDING TENANT AREA ONLY PROJECT Al1l;A ONLY i i Bulletin # 100 — February 19, 2020 Page 2 of 2 k:\I-Iandouts\Permit Application RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR (or Mobile Home) III -ID 11 I ZO SECOND FLOOR ...__....... __..___ COVEREM 1?NTRY t DECK GARAGE [A CARPORT ❑ y OTHER (describe)'( Area Totals ex[srnro PRoroeau T♦11'AL �-�. ��-�— **JaworlV'LY** ESTIMATED SELLING PRICE $ V L' # OF BEDROOMS COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information 8 uare Feet Tye Stories NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information Square Feet a Stories TOTAL. BUILDING TENANT AREA ONLY PROJECT Al1l;A ONLY i i Bulletin # 100 — February 19, 2020 Page 2 of 2 k:\I-Iandouts\Permit Application COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information 8 uare Feet Tye Stories NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information Square Feet a Stories TOTAL. BUILDING TENANT AREA ONLY PROJECT Al1l;A ONLY i i Bulletin # 100 — February 19, 2020 Page 2 of 2 k:\I-Iandouts\Permit Application Bulletin # 100 — February 19, 2020 Page 2 of 2 k:\I-Iandouts\Permit Application