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21-100674-Building Permit Application-02-26-2021-V1 (1)"'A: CITY OF Federal Way PERMIT APPLICATION PERMIT CENTER + 33325 80� Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permitcenteiCa cityoffederalway.com PERMIT NUMBER _ _ TARGET DATE SITE ADDRESS SUITE/UNIT N Z`73� SW 3g7TH r FID EPAL- W14-y WA �� PROTECT VALUATION ZONING ASSESSOR'S TAX/PARCEL M Z4 Q o $ 2S, 0 0 0 P, - TYPE OF PERMIT k $ ILDJNG [ PLUMBING © MECHANICAL 11 DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT MELUM.SAJ,�,Z AEU PROJECT DESCRIPTION Detailed description of work to ` be included on this permit only NAME T MA PRIMARY PHoNEr - 735 - 3-Y3Z- PROPERTY OWNER MAILING ADDRESS E-MAIL Z y7)h PL °ITY Li,'1 STATE A LIPgo 3 NAME PHONE MAILING ADDRESS E-MML CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE d EXPIRATION DATE UBI 4 NAME i YlZZ PRIMARY PHONE MAILING ADDRESS 3 �f L E-MAIL APPLICANT CITY z-A� STATE ZIP FAX NAhqg i—L Y /! PRIMARY PRONE Z-V 1 — y PROJECT CONTACT MAILING ADDRESS -31� e YI v'-- `� +E-MAIL 7 IA) 6 (The individual to receive and respond to all correspondence CITY STATE L'4-"-,,- IlV.9 ZIP q'Vl W 11 FAX concerning this application) NAME LJ�OWNER-FINANCED PROJECT FINANCING When value is $5,000 or more MAILING ADDRESS, CITY, STATE, ZIP PRONE (RCW 19.27.096) 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 Iaws 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 }I led 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 apart of this application. SIGNATURE: DATE � 4 ) z%, — 17- LL:-�P� PRINT NAME: 112 yID'e7 Bulletin #100 - Febmary 19, 2020 Page 1 of 2 k:lHandoutslPermit Application MECHANICAL PERMIT VALUE OF MECHANICAL ere:. I e ° uture to oe msatuea or relocatea as part ol Inns project. Do not include e)dsyng Lyntres to remain. AIR HANDLING UNITS — FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER _ FIREPLACE INSERTS HOODSIcommerriwj BOILERS _ FURNACES HOT WATER TANKS prryj COMPRESSORS - GAS LOG SETS REFRIGERATION SYST _ DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT VA LUE OF PLUMBING WORK Indicate how many of each yj2e a LYture to be installed or relocated as Part of this project. Do not include existing brtures to remain. BATHTUBS for Tnn/Sh w rco ntoj DISHWASHERS _ DRAINS _ DRINKING FOUNTAINS _ IIOSE BIBBS _ LAVS (Nand SChel TOILETS WATER PIPING RAINWATER SYSTEMS URINALS OTHER (Describe) SHOWERS VACUUM BREAKERS SINKS (same /wail,) WATER HEATERS (rimr;0 SUMPS WASHING MACHINES TOTAL FvrruE .8 GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? No WATER PURVEYOR SEWER PURVEYOR VALUE OF=aTINa IMPROVEMENTS IOa8TIN0(PRBVIOUB USE n I= 812E Iln Square Peet) EXISTING FIRE BPRIRW.ER SYSTEM? r Yes No PROP08ED FIRE SUPPRE8810A SYSTEM? Yes /,No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT 3 D O 930 . .... _........_........... FIRST FLOOR (or Mobile Home) SECOND FLOOR ...... _,........... ................ .. . ............................. COVERED ENTRY .... ..... _.. ....................._............................ DECK eI �ip® ................................................................................................................................. GARAGEsL� CARPORT L OTHER (describe) Area Totals ........................ __................ . --NEW HOMES ONLY-- ESTIMATED SELLING PRICE $ # OF BEDROOMS COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in S uare Feet Occupancy Grou s P Y PI) Construction # of Stories Additional Infer NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area S uare Feet Occu an Group(s) P cY PIs 1 Construction Type # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100— February 19. 2020 Page 2 of 2 kAllandoutsTermit Application