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21-102156 - APPLICATIONiroA I -� Crinifr ,4% CITY OF Federal Way , PERMIT APPLICATION PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permitcenteracityoffederalway.coin r r PERIYILT NUMBER, _ TARGET DATE° y SITE ADDRESS ►v SUITE/UNIT PROJECT VALUATION 2 ZONING ASSESSOR'S TAX/PARCEL # 0 3 0 q4 TYPE OF PERMIT ;�l BUILDING ❑ PLUMBING © MECHANICAL IJ DEMOLITION 0 ENral-NEERINo M FiRE PREVENMN NAME OF PROJECT `L PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME - PRIMARY PHON o-142— .-. PROPERTY OWNER �N� RES$ + r;.iII,� � 6. 'y UP "P 1,�` _ N 1.1L9 b, al4_- d � 1 �PHONE P /' i[Ui ��`+f IrhiAIL CONTRACTOR y C'I7'i t Zlfp�� f /y� AR �1 I tau . � �! ASTATS CONTRACTOR'S MCENS& # � ""}}��JJ ..y 3EXPTRATION AT � Il lI I #04 — j,-1c)— ya, f Jt ` G L`�IL LdJ/ gr� PRIMARY ON8 r MNr E-15SAIL a6 ' APPLICANT Mvwra STATF 2I�"']r� . AX PROJECT CONTACT // t j 14 1b E veal ; (The individual to receive and respond to all correspondence concerning this application) Yug i' PROJECT FINANCINGJ&a e %�I OWNER -FINANCED LING�DRESS, CITY, +/�A� el,/i1 STATE, ZIP ,%r/1 +4PHO0 V t�1V111 When value is $5,000 or more (RCN! I9.27.095) 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 owners responsibility for compliance with local, state, or federal lazes 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 he 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. r 2 � J `_ 1 SIGNATC7 DATE 4 PRINT NAME_ 4- R„ 1letin 4100 — l'ebrllary 19, 2020 Page i of 2 k:lHandouts'%Permit Application MECHANICAL PERMIT Indicate how many of each AIR HANDLING UNITS AIR CONDITIONER BOILERS COMPRESSORS DUCTING PLUMBING PERMIT Yr; ,~e to be installed or ref FANS FIREPLACE INSERTS FURNACES GAS LOG SETS GAS PIPING rxtures to remain. OTHER (Describe) Indicate how many of each type offixture to be installed or relocated as part of this project, Do not include existkgf22qures to remain. BATHTUBS (or Tub/Shower Combo) LAVS pandsiow] �_ TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS Z SINKS (Kitchen/Utuit) WATER HEATERS (Elect iq HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVNYpR VALUE -OF MUSTING-IMPROVEMENTS - - EXISTING/PREVIOUS USE LOT SIZE [In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? D Yes ❑ No ❑ Yes o No RESIDENI`IAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR COVERED ENTRY DECK ........... -----...... ------ ............................ ... _....... _.__............... .................. GARAGE ❑ CARPORT ❑ 'OTHER (describe) ............ _....... -.................................... _... ---............................. _..... _......... Area Totals xMSTMG PROPOSED TOTAL - �.................... ..--....................... -........................... " NE:W HONES ORLY" ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS COMMERCIAL - NENVADDITION AREA DESCRIPTION Area in S uare Feet Occupancy Group(s) Construction a # of Stories Additional Information NEW BUILDING. ADDITION COMMERCIAL 1REM.ODEI.,/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Groups) Construction Type # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY - - - Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application