22-100045-SF-Building Permit Application-01-06-2022-V141k
CITY OF �
Federal Way
PERMIT NUMBER
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenteracityoffederalway.com
-- TARGET DATE
SITE ADDRESS: 34712 31st PI SW Federal Way WA 98023
SUITE/UNIT N
PROJECT VALUATION
ZONING ASSESSOR'S TAX/PARCEL M
TYPE OF PERMIT
M BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTION
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Detailed description of work to
Z, W
be included on this permit only
NAME
Ashw,,�, - Vrct7AZPWSl� <
PRIMARY PHONE
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PROPERTY OWNER
MAILING ADDRESS
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E-MAIL,-MA"
Ci�y
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NAME
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PHONE
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MAILING ADDRESS
kAOPI, S"S 2A��b- G�W�
E-MAIL
CONTRACTOR
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CITY STATE ZIP .�r�
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FAX
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE UBI (t
NAME
Ay resh P11
PRIMARY PHONE
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APPLICANT
MAILING ADDRESS
101 . r�i�4i" STi2CC1
E-MAIL
CITY -^J �STATE1 ZIP Q
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FAX
PROJECT CONTACT
NAME (J
Q�ilY1QS�C1 ` `1
PRIMARY PHONE
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(The individual to receive and
respond to all correspondence
MAILING ADDRESS
\QJ3:1 GL.3 Cx Qc--rr
E-MAIL
concerning this application)
CITY STATE ZIP
FAX
PROJECT FINANCING
NAMEse
^`/�
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OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27,095)
MAILING ADDRESS, CITY, ST , ZIP
PHONE
5 q t024,
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 Iocal, 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 defens of such claim), which maybe made by any person, including the undersigned, and filed against the city,
but only where such c4c:1-
� out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied toa p�Irt of this application.
SIGNATURE: DATE Q,Lo
2
PRINT NAME:+ In t�� Cw1
Bulletin 4100 —February 19, 2020 Page 1 of 2 k:lHandoutsTermit Application
MECHANICAL PERMIT
Indicate how many of each type
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
PLUMBING PERMIT
f.Pxture to be installed or re!
FANS
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
GAS PIPING
�w�<< a
ucture to oe tnstatiea or rei,
BATHTUBS J- Iltb/Shower Combo)
LAVS )Hand Sinks)
DISHWASHERS
RAINWATER SYSTEM
DRAINS
SHOWERS
DRINKING FOUNTAINS
SINKS (Kitch_/UtWtyj
HOSE BIBBS
SUMPS
GENERAL INFORMATION
CRMCAL AREAS ON PROPERTY? I WATER PURVEYOR
VALUE OF MECHANICAL, WORK
s N o.
as part o f this project. Do not include existing frxtures to remain.
GAS PIPE OUTLETS
OTHER (Describe)
HOODS pomm jai)
HOT WATER TANKS )Gas)
REFRIGERATION SYST
WOODSTOVES
VALUE OF PLUMBING WORK
N a
as Part of this 2roiect. Do not include existing fixtures to remain.
TOILETS
WATER PIPING
URINALS
OTHER (Describe)
VACUUM BREAKERS
WATER HEATERS (Electr c)
WASHING MACHINES
TOTAL FIXTURES
SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet) PR
EXISTING FIRE SPRINKLER SYSTEM? OPOSED FIRE SUPPRESSION SYSTEM?
Yes ❑ No Yes No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals EXISTING PROPOSED TOTAL
"*NEW HOMS ONLY"*
i-NIIMAI'EL) SELLING PRICE $ 1 # OF BEDROOMS
FOR OFFICE USE
Bulletin #100 —February 19, 2020 Page 2 of 2 UHandoutsTermit Application