20-104041-Residential Building Permit Application-10-22-2020-V14k
CITY OF
Federal Way
PST NUMMR
srr� AnDl�ss
FROM= ❑ "ATIOii
$ 9 vV
TYPE OF PERMT
NAME OF PROJECT
P PT APPLICATION
PERIIIIT' CENTER + 332q Sth Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcentex@cityaflederaiway.carn
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ZONING A987
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W IMMUNG ❑ (PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
l . � n e�rz +�,. ! �' �aS'7�nTF � �.--� � Ci"� � .i���►f l �/
PROJECT DESCRIPTION -
Detailed description of "rk to
be incUided on this permit only ex
PROPERTY OWNM
CONTRACTOR
PROJECT CONTACT
[T°he individual to receive and
respond to ail correspondence
concemuV du!s applieation.)
PROJECT FINANCING
When value is $5,000 or more
{RCW 19.27.a95)
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NAM
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WA STATE CONTRA
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FAX
3-590.
OWNER FMANCED
l &MM ADDRY.SS, FrW
STATE, zw
PMM
I c-ft und- PenaItil of Ped+ry that I am the I
of crap knawledge, the information submitted in sup,
all applicable City of Federal Way regulations pert
issuance of this permit doss not remove the oun
construction or environmental laws.
I further agree to hold harmless the City of Fede
the Investigation 4n d dsfenss of such elaimb which
but only where such claim arises out of the retie
in formation =Wlied to the city as a part of this up
q^111 ..
SIGNATUM
PRINT NAME: Y r L Y
eft owner or authorized agent of the property owner. I certo that to the best
of this pemdt application is true and correct. I Carlini that I Will OQMPW with
tog to the work authorised by the issuance of a permbL I undmrstand that the
i responsibility far compliance with local, state, or federal laws regulating
Way as to - W claim (including casts, expenses, and attorneys' fees incurred in
p ba meads by a*Wporvon, h-eluding the andereig-4 and./llad agai—t Me sit*
of the city, including its offlaaers and employees, upon the accuracy of the
Bulletin #100 -February 19, 2020 1' Page 1 of 2 k:lHandouts\Permit Application
MECHANICAL PERMIT
untttE OFMECNAN(CAL WORX
Indicate how mmyofeach type offtclure
to be'
'a led or relocated as
art o this ro' ct. Dc not include ecis ' us to remaa4
_ AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Deacribel
_ AIR CONDITIONER
F/REPLA
EINSERTS
HOODS jc�)
_ BOILERS
FUMAC
eS
HOT WATER TANKS Is,
_ COMPRESSORS
OASLOC
SETS
REFRIGERATION $YS
DUCTING
GASPITMIG
WOODSTOVES
PLUMBING PERMIT
_ BATHTDBS,,n/enowvc—m
LAVS
atw�
TOILETS WATER PIPING
_ DISHWASHERS
RMNWA
ER SYSTEMS
URINALS OTHER tDc.nbe)
DRAINS
SHOW
VACUUM BREAKERS
DRINEING FOUNTAINS
am,,
�Naarl
WATER HEATERS
❑ Yes o NO
In Yes O No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in egos t, feet( E)INd ING PROPOSED TOTAL FOR OPRICB DNE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR '
:01Le70a 0e71` I-M
DECK
GARAGE ❑ CARPORT ❑
OTHER (desca'be) �ip1M�
Area Totals
COMMERCIAL - NEW/ADDITION
ON
AREA DESCRIPTIOR
Area in
8 ears Rest
GronlNe)
Conatrnetioa
# of
Etoaiw
Additional n l s&enatio
NAHRD.DDIa
ADnT Op
COMMERCIAL— REMODEL/TENANTI
APROVEMENTS
AREA DESCRIPTION
� in
oapaany Oronp(a)
Conetraatloa
ostauifw
Additional Ia[ormatien
To m, EaDmamu,
'..
TB.MIPC Aden aln.Y
Ppa. AREA OpLY
Bulletin #100-February 19,2020 Page 2 of2 k:INandmb\Peanit Application