21-103193-ELSA DEMSSIE PERMIT APPLICATION-07-31-2021-V1RECEIVED
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CITY OF AUG 0 5 2021
PERMIT APPLICATION
Federal WayPERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER _ I V 3 1 _
— TARGET DATE
SITE ADDRESS SUITE/UNIT #
30451 111h Ave S
PROJECT VALUATION
ZONING
ASSESSOR'S TAIL/PARCEL #
$6,000
RS7.2
O 9 1 9 O O — O 2 9 O
TYPE OF PERMIT
IkUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Bathroom renovation and adding one window.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
Elsa Demssie
206.458.0223
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
30451 11th Ave S
CITY STATE
ZIP
Federal Way WA
98003
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME
PRIMARY PHONE
Michael Ashinay
206.458.0223
APPLICANT
MAILING ADDRESS
E-MAIL
14502 46th PI W
Michaelashinay@gmad.com
CITY
STATE
ZIP
FAX
Lynnwood
WA
98087
NAME
PRIMARY PHONE
PROJECT CONTACT
Michael Ashinay
206.458.0223
MAILING ADDRESS
14502 46th PL W
E-MAIL
Michaebzhinay@gmail.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Lynnwood
WA
98087
PROJECT FINANCING
NAME
Elsa Demssie
■OWNER -FINANCED
When value is $5,000 or more
(RCW 19.2Z095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
30451 1Ith Ave S, Federal Way, WA, 98003
206.458.0223
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: DATE 7/31 /21
PRINT NAME: MICHAEL ASHINAY
Bulletin #100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $0
Indicate how many of each type offixture to be installed or relocated as part 2L this project. Do not include existing _ftixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
(SEPARATE PERMIT)
Indicate how many of each tyjoe
offLxture to be installed or relocated as j2art
o this project. Do not include existingfixtures to remain.
BATHTUBS (or Tub/shower combo) LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/Utiiiry)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ 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)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals
EXISTING
PROPOSED
TOTAL
o
"AE W HONES ONLY"
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS ,5
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s) Construction
Type
# of
Stories
Additional Information
NEW BurwiwG
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
TOTAL BOILDING
TENANT AREA ONLY
PRO"= AREA ONLY
Bulletin # 100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application