20-104989-Building Permit Application-12-21-2020-V1CITY OF ,.�
Federal Way
PERMIT NUMBER _
PERMIT APPLICATION
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenterC cityoffederalway.com
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
504 S. 310th PLACE; FEDERAL WAY, WA 98003
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 65,000
RS7.2
2 4 1 3 3 0_ 0 9 8 0
TYPE OF PERMIT
L[ BUILDING X PLUMBING M MECHANICAL, DEMOLITION El ENGINEERING El FIRE PREVENTION
NAME OF PROJECT
BERIHUN ALTERATION & ADULT FAMILY HOME
INTERIOR ALTERATION ON 1 ST FLOOR ONLY. CONVERT GARAGE
PROJECT DESCRIPTION
Detailed description of work to
INTO BEDROOMS. ESTABLISH ADULT FAMILY HOME
be included on this permit only
NAME
PRIMARY PHONE
MELKAM BERIHUN
206.434.6245
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
504 S. 310th PLACE
CITY
FEDERAL WAY
STATE
WA
ZIP
98003
NAME TO BE DETERMINED
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME DAN V. GARVIDA
PRIMARY PHONE
206.261.2418
APPLICANT
MAILING ADDRESS
12613 SE 237TH PLACE
E-MAIL
DanGarvida@gmail.com
CITY KENT
STATE
WA
ZIP
98031
FAX
NAME DAN V. GARVIDA
PRIMARY PHONE
206.261.2418
PROJECT CONTACT
MAILING ADDRESS
12613 SE 237TH PLACE
E-MAIL
DanGarvida@gmail.com
(The individual to receive and
respond to all correspondence
CITY KENT
STATE
ZIP
FAX
concerning this application)
WA
98031
PROJECT FINANCING
NAMEOwner Financed
IXJ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19, 27, 095)
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.
Dec 10, 2020
SIGNATURE: DATE
DAN V. GARVIDA
PRINT NAME:
Bulletin #100 —February 19, 2020 Page 1 of 2 k:AHandouts\Permit Application
MECHANICAL PERMIT
Indicate how many of each typ
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
2 DUCTING
PLUMBING PERMIT
BATHTUBS (or Tub/shower combo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
fixture to be installed or relocated as
2 FANS _
FIREPLACE INSERTS _
FURNACES _
GAS LOG SETS _
GAS PIPING
1
LAVS (Hand Sinks)
RAINWATER SYSTEMS
1
SHOWERS
1
SINKS (Fachen/utility)
SUMPS
1 TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES
g fixtures to remain.
OTHER (Describe)
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
LAKEHAVEN
LAKEHAVEN
58,500.00
$
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Yes X No
Yes X No
SINGLE FAMILY RES.
7,200
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
0
0
0
...............................................................................................................................
FIRST FLOOR (or Mobile Home)
1320
200
1520
...............................................................................................................................
SECOND FLOOR
1550
0
1550
...............................................................................................................................
COVERED ENTRY
0
0
0
...............................................................................................................................
DECK
200
0
200
...............................................................................................................................
GARAGE N CARPORT ❑
200
-200
0
...............................................................................................................................
OTHER (describe)
...............................................................................................................................
Area Totals
EXISTING
3270
PROPOSED
0
TOTAL
3270
...............................................................................................................................
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $
1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
T e
# 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 ARF,A ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application