04-104613 )Y - i 0
Y_L,Federal Way I IRECuEQ PEX
SF MF CO ME EL PL DE ENO
COMMUNITY DEVELOPMENT SERVICES
3332 8r"AVENUE SOU771•Po BOX 9778 L� 2I P L I C AT I O N TD
EDEILIL WA ,WA 9863-9778 /
253-835-2607E •FAX 253-8352609 /
www aluoffederalwau.com
The following is requl d._A o_' 14•�•A'l'lcomplete a.•lication will not be acce•ted. Please •rint legibly(in ink)or type.
.;. NO PROPERTY INFORMATION
r
SITE ADDRESS I�w • � SUITE/UNIT#
ASSESSORS TAX/P• •$g`#�-S-- — — _- LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page f lengthy legal desoip ion)
■ PROJECT INFORMATION,
TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING IRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
11660 Fa& , ctp�s'— C9I--%
PROJECT NAME(Name of Business or Owner Last Name) A Q C' ° CeC 1-1 ,/ f�-QS/
U PEOPLE INFORMATION
PROPERTY NAME CiL PRIMARY -HONE
OWNER � 1/
MAILING ADDRESS CITY,STATE,ZIP
CONTRACTOR COMP NY NAME 677 APP ICANT N OFF E PHONE
577 'T760 — , c,u ,— 4 IR6, - 3S 2
Al (/y�G�ADDRESS///jt .._y ,STATE,ZIP l `�'"/�� q CELL PHONE
'';/��-C`.%�
// O �9L BUSINESS N(UcM-BER - e�H EXPIRATION DATE (eyes-)
6 1_ - 6��/
CX NUMBER
B L / / (�''" gg?
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
/ /
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT • FAX NUMBER
0 Architect 0 Tenant 0 Agent 0 Other(Describe) ( ) - I
CONTACT 0,
NAME ri PPtiplARY PHONE E-MAIL ADDRESS
f/kI5 Likatez, 0.5-) z( - 6?S7
LENDER f Per RCW 19 27.095 ',Lender information is NAME
required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP
, .-. DETAILED BUILDING INFORMATION .
EXISTING USE PROPOSED USE
00
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ C-> Q, �^
SPRINKLERED BUILDING? ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? a YES a NO
' . WATER SERVICE PROVIDER 10-1.AI SHAVEN ❑ HIGHLINE a TACOMA a PRIVATE(WELL)
SEWER SERVICE PROVIDER ca-LAKEHAVEN ❑HIGHLINE a PRIVATE(SEPTIC)
AREA DESCRIPTION PROJECT FLOOR AREAS
Q.FT. PRO"•SED SQ.FT. TOTAL
BASEMENT -T
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE) •
DECK(COVERED?)
GARAGE/CARPORT
_ TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING MD PROPOSED
HOW MANY FLOORS?
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES'
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
• MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(cotnmudall W OODSTOV ES
' BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS or Tub/shoaercombol SHOWERS WATER CLOSETS(rotleq MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
--'=DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
ant authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,but only where such claim
arises out of the reliance oft ity,inclu n its officers and employees,upon the accuracy of the information supplied to the city as a part of
this application.
NAME/TITLE '�� 'A [_ 4 DATE // o i
(Signal Tel I (Clue)
S RELATIONSHIP TO PROJECT ❑ Owner o Agent ontractor ❑ Architect ❑ Other
F
+ FOR OFFICE USE ONLY
o NEW ❑ADDITION a ALTERATION a REPAIR a TENANT IMPROVEMENT
f BUILDING SHELL ONLY? o YES ❑NO BASIC PLAN? a YES a NO
I ZONING DESIGNATION CHANGE OF USE? a YES a NO
t NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? o YES a NO
PLATTED LOT? o YES ❑NO DEMO PERMIT REQUIRED? o YES o NO
• ,
{ •
—
Page 2 of 4 k\Handouts—Revised\Permit Application
Bulletin#I00—March 30,2004 g
i
ETTER DETAIL FOR RACEWAY MOUN
PAN CHANNEL LETTERS
ALL SIGNS AND COMPONENTS ARE UL APPROVED AND
MEET STATE AND LOCAL BUILDING AND ELECTRICAL CODES
SHEET METAL LETTERS - BACKS & SIDES
EACH LETTER WEIGHS APPROXIMATELY 2 1/2-3 LBS.
SHEET METAL
RETURNS
1"TRIM CAP
GLASS STAND
O 1 1/2" -IDLE PER LETTER
C l WITH PK
1/2 FLEX CONNECTOR
PLEX/LEXAN FACE
1/2"FLEX CONDUIT
1 IIGH TENSION WIRE
L� ACCESSIBLE GROUNDED
METAL RACEWAY ENCLOSURE
41
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FACES AS NEED AROUND -4111- 5" ---0"11-7 1/4-►
EACH LETTER
DEPTH OF EACH
LETTER
WALL
NO SCALE
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