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21-103629 - Permit Application - 9-1-21 - V-1.k 7-, -D CITYOF �.�-_ r- PERMIT APPLICATION PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325 Federal Way 253-835-2607 + FAX 253-835-2609 + permitcentelf&_cityoffederalway.com PERMIT NUMBER — — TARGET DATE —A � A P SITE ADDRESS 3,52 O 1� 4 f ' L. S,\ 4 SUITE/UNIT k C-- 0rL, W 9 0 2-3 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL # $ 3c7,���,o TYPE OF PERMIT BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT D ldi- <_1 4E N C L. 0 S td R C- C^ & `'� „' �� ) F ©�.4 rz. Sp A W u E ACr U 1R PROJECT DESCRIPTION Detailed description of work to p4�A sW �J G t.. L be included on this permit only 'r I � 1 M 47 C � °"'°' r c� X 15 NAME ✓ PRIMARY PHONE PROPERTY OWNER DR MAILING ADDRESS s o �'/ , s wo E-MAIL FED E2 QL. W A k%� ZIP NAME PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE UBI # NAME PRIMARY PHONE APPLICANT MAILING ADDRESS 3 S 0 -ram �L. E-MAIL CITY F � EY:� A-L- \A1A. STATE WA, ZIP Q `7 adZ3 FAX NAME PRIMARY PHONE PROJECT CONTACT (The individual to receive and MAILING ADDRESS -2-.Z S T /^T � "� v E-MAIL t� k� 13W O C respond to all correspondence � l.� I ,S- o M CITY—.. 4 oM A-W STATE A, ZIP q iM19I• CA-5 -T. N E7 concerning this application) PROJECT FINANCING NAME 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: — Egin Q//ua-4 DATE �� �' PRINT NAME: '�25'ff /U 1-1Q—/ 1 J l Bulletin #100 - February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application _ -f ALUF. of AftSC6/ANICAI, 11'01?K MECHANICAL PERMIT Fl L -,� ZI --I D 7 G> _ �- $ � Indicate how many of each tjpe offixture to be installed or relocated as part of this project. Do not include existin rxtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS,c—.,--jwi BOILERS FURNACES HOT WATER TANKS;(;;,,, COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTO VES IALU: or• Pt.UA1H1A'G li'oNK PLUMBING PERMIT $ C> Indicate how many of each tjpe o fixture to be installed or relocated as part of this prgiect. Do not inchide eristin fixtures to remain. BATHTUBS,., wvsno,,.,co Nj LAVS ,,w., s;.,k,I TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS HOSE BIBBS SINKS ,>tkk,,nmr,,, SUMPS WATER HEATERS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? 1V'ATER PURVEYOR SEWERPURVEYOR VALUE OF FXIST/Nf. IMPROVEMENTS 0 �) 1_ EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINNZER 'YSTEM? D Yes No PROPOSED FIRE SUPPRESSION SYSTEM? 0 Yes No RESIDENTIAL - NEW OR DITION AREA DESCRIPTION (in square feet) V EXISTING PROPOSED TOTAL FOR OFFICE 17SE ..................... ................................................... -..................... ............. - BASEMENT FIRST FLOOR (or Mobile Home) ........................................................................................................................... SECOND FLOOR .................................................................................................. ........................... ............................. ................... ........... .-................. ................ COVERED NTRY DECK = 2 �' PE C.R EA 1 DA 2 (p GARAGE ❑ CARPORT ❑ OTHER (describe) ................................................................................................................ Area Totals EXISTING PROPOSED 2/ e TOTAL 2 I G ........................................................................................................................... **NEwMONIES ONLY** ESTIMATED SELLING PRICE $ ?C) O b J r ` �" — # OF BEDROOMS COMMERCIAL — NEW/ADDITION /Q. A a AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information NEw BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin 4 100 — February 19.2020 Page 2 of 2 k:\Handouts\Permit Application