21-101295-BUILDING PERMIT APPLICATIONCITY OF
RMj.T APPLICATIOIIT
Federal Way
PERMT NvmBErt
OFTE ADDRFA&B
CONTRACTOR
PIA'
PROJECT CONTACT
I I ne iia UAW to rc:c. i ve. ana
respand to all carresporuience
m� the a p hcation)
�OJECT FINANCING
When value is $5, 000 or more,
P?C1.095)
RIT
CENTER
+
33325 80h
A%rcnuc South
li"edirval Way, 8
-
3- 6
FAX -
-
-. I TARciET DATA 5/1/21
ASSESSOR'S TAXIPARCEL 0
Wei STATE CONTRACTOR'S LI GE 0
:.�
AILING ADDR
ALEXANDER BERGMAN
"lAn I'.!Q ADDP vF4
1422 N ANDERSON ST
nrs
TACOMA
00- ...
MA LING ADDRESS, CITY, STATE.. ZIP
EXPLRATION DATE
STATE I ZIP
STATE zi x)
WA '
TE I NIT
PRIORY PRONE
I -A
FAX
PRtKAJrt PHvUZ
360-280-0528
a.r.bergman1 01 @gmail-com
F
El UWNER-FINANCED
PHONE
rU u� r a t or c f the propel owner, I cerQ that to the best
of my knowledge, the jr ormatjon submifted in support of this permit application is true and correct. I ccrfUy that I will comply with
■
all pjjcabje City of Fe ra l PVa_y re bons pertaining to the ujork authorized issucmce of a pcm fit. I understand that the
anoe of 0tis permit does not remove the own is responsiblZity for compliance with local, state, or federal laws rcgulating
co trurtin" nr en&4ronmerttxz1 laws.
Iftertheir agree to hold harmless the City of Federal Way as to any claim (including casts, p s# and a to rrz s' fee3 incurred in
the in er t igatiorz and defense of such claim), which may be made by any person, including the undersigned, and filed against the sty*
but only where such claim se-9 out of tit eliance of thr city, eluding its officers and emplo ecs, upon the airr-uracy of the
Wo r a on su pUed to the 6 ty a part at o
•
SIGNATURE -
r--' l DATE ,I31 / ZUL
�3��I�c�in �iOU -- Feb n��' 19, ��?!
l Page I v1'2 kAlandouts4lermit Application
MECHANICAL PERMIT
Indicate each t
All? IIANDIIN 0NIT
AIR CON 1110 N ER
11 I 111' 1
COMPRESSORS
I- C n N
P1--dUMBtNG PERMIT
Indicale hjDWmartziof each tuvi
DISHWASIiERS
MIS
DRINIONG FOUNTAINS
TIOSE 111I I3
'fixtureto be metalled or r local ed a a
MANS
FIREMACE INSERTS
RTS
FU RN AC P;u
GAS LX)G SM
OAS P1 FqN0
VAAIJ,FAft-x.-IJ ICAL WORK
$ 200
9 the r 'er. Do not vw1 d e-ln'stlres to r rn airL
CAS PIPE LM1,OTI IE (r3escribel
I JOT WATER TANKS-
REFRIGE-RA110N SYT
WOODSTOVES
Au IF OF PW ZINC WORK
$ 1500
2L�e to be uisf a tied or re 1cca ted as, p art of the r . Do not tnelu d e eja s I i ng res to rem a vt
p s, To l l.,I WATER PI N
SIN (Kiubm/Litaim WATER HEATERS (a �
SUMPS AS I C I N MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CiUT[�AL AREAS Otf PROpERT'Y"r WATER PUAV�'TOR 6EWER PLFRVLrYQR VALITE Of t.XlS7TNt3 iblPROYEMfN"FS
NO
rMsTIrrc � Pairvians USE
SFR
LAKEHAVEN
L[7"l' iII= [ifs Square Feet--
7.520
RESIDENTIAL - NEW' OR ADDITION
AREA DE-SCRIPTION (in square feet)
.c,--;T F (or Mobile Home)
SECOND 1#1-.,0l
ENTRY
I
GARAGE 0 CARPORT 0
0141 11:12 (desenbe)
---
Area Tota Is
V.STIMATIFiD SELLING PRICE $
=STING
910
LAKEHAVEN
T I N G Ft PRIM L SYST 7
Yes Ej No
PROPOSED
11330 165
1240,
-j L
2.7 Ir
165
PROPS36i:h
()I� 13 VI )RO CMS
TOTAL
TXrrAL
2935
4,000
PROPOSED SUPPRESSION STWI
Yes v No
FOR OFFICE USE
COMMERCIAL — NEw/ADDYFION
AREA DESCRIPTION
Area in
Square Fcet
Occupancy Group(m)
- --- -
Construction
'I�pe
# of
Stories
Additional information
New BUILDING
AnozTroN
COMMER(-"IAL -- REMODEL/TENANT IMPROVE'.%MENTS
AREA DESCRIPTION
Ares in
Square Feet
Occupancy Group(B)Additioual
--- _
Caastr�xctio�
_. T ''Pe
� of
Stories
Information
TUTAL BLIIi.U111iG
--
TElYAl'!T Aki A []1VLY
i
PRWECT AREA OK%.Y
NIPS
f �itlei xn # 1 — I-chm� 191, 2 1"a fkAllandouts\Permil Application