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21-103037-00-Building Permit Application-07-23-2021-V1CITYOF PERMIT APPLICATION Federal Way PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + penniteenteo_w-cityoffederalway.coTn PERMIT NUMBER L — TARGET BATE SITE ADDRESS 3,G: PROJECT VALUATION TYPE OF PERMIT NAME OF PROJECT PROJECT DESCRIPTION Detailed description of tuork to be included on this permit only PROPERTY OWNER CONTRACTOR APPLICANT PROJECT CONTACT (The individual to receive and respond to all correspondence concerning this application) PROJECT FINANCING When value is $5, 000 or more (RCW I9.27.095f �`y SUITE/UNIT # ZONING ASSESSOR'S TAX/PARCEL# l "/ -s 6 (-) - CI BUILDING ❑ PLUMBING 11 MECHANICAL ❑ DEMOLITION ❑ ENGINEERING © FIRE pREVENTIQN NAME MAILING ADDRESS clrY A, Lo-VI NAME rM MAILING ADDRESS CITY WA STATE CONTRACTOR'S LICENSE # NAME MAILING ADDRESS CITY NAME MAILING ADDRESS CITY NAME 17�11�r MAILING ADDRESS, CITY, STATE, ZIP STATE I ZIP s �%ir t"PLts PRIMARY PHONE E-MAIL PHONE E-MAIL STATE ZIP ::Z EXPIRATION DATE PRIMARY PHONE E-MAIL STATE ZIP FAX PRIMARY PHONE E-MAIL -TAT- ❑ OWNER -FINANCED PHONE I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. !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 t t o the 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 file investigation and defense of such claim), which may he made by any person, including the undersigned, and ftled 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: DATE <�it7.-off 4 PRINT NAME: rl i CJI( I Bulletin #100 —February 19, 2020 page 1 of 1c:1f3alidoutslPcrinit Application MECHANICAL PERMIT �VALUE OPMRCHANICAL WORK Indicate hoof man Of each type of rxture to be installed or relocated as Part of this praiect. Do not include exist ixtures to remain. AANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (Co,,,,, —I) BOILERS FURNACES HOT WATER TANKS (Gast COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT indicate now rmany o each twe offixture to be installed or relo, BATHTUBS (.,T L,/Sh--r C—L6) LAVS )Eland Sinks) DISHWASHERS RAINWATER SYSTEMS DRAINS SHOWERS DRINKING FOUNTAINS SINKS (Kitchen/Dthty) HOSE BIBBS SUMPS GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR EBISTINGIPREVIOUS USE LOT SIZE (In Square Feet) RESIDENTIAL - NEW OR ADDITION a.s art of this project. Do not in TOILETS URINALS VACUUM BREAKERS WATER HEATERS (Soma) WASHING MACHINES VALUE OF PLUMBING WORK Iude existingfixtures to remain. WATER PIPING OTHER (Describe) TOTAL FixCTIJRE3 SEWER PURVEYOR I VALUE OF EXISTING IMPROVEMENTS EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? Yes ❑ No ❑ Yes ❑ No AREA DESCRIPTION (in Square feet) EXISTING PROPOSED TOTAL BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR COVERED ENTRY DECK O GARAGE ❑ CARPORT ❑ OTHER (describe) Area Totals 1. i3MTING PROPOSED TOTAL **NEW HOfidW ONLY" ESTIMATED SELLING PRICE $ I # OF BEDROOMS I FOR OFFICE USE Bulletin #100 -- February 19, 2020 Page 2 of 2 k:lHantloutslPermit Application