22-100390 Permit application41k
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 + permitcenter@cityoffederalway.com
TARGET DATE 1 /22/2022
SITE ADDRESS
SUITE/UNIT #
32624 39th pl federal way wa 98023
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 7,000
8 7 3 1 9 5 _ 1 6 7 0
TYPE OF PERMIT]
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
robert house project
we will convert dining room and add a wall to divides ace and convert to bedroom
PROJECT DESCRIPTION
Detailed description of work to
walk way with hand railings
be included on this permit only
NAME
PRIMARY PHONE
robert
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
32624 39th pl federal way wa 98023
CITY
STATE
ZIP
federal way
wa
98023
NAME
PHONE
luis
2532245102
MAILING ADDRESS
E-MAIL
CONTRACTOR
4428 country club dr
joseacosta588Rgmail.com
CITY
STATE
ZIP
FAX
tacoma
wa
98422
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
9 / 31 / 22
604148898
NAME
luis
PRIMARY PHONE
2532245102
APPLICANT
MAILING ADDRESS
4428 count club dr
E-MAIL
joseacosta588@gmail.com
CITY
STATE
ZIP
FAX
tacoma
wa
98422
PROJECT CONTACT
NAME
lugs
PRIMARY PHONE
2532245102
MAILING ADDRESS
4428 country club dr
E-MAIL
joseacosta588@gmail.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
tacoma
wa
98422
PROJECT FINANCING
NAME
❑ 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.
SIGNATURE: 'J O 5DATE 2/ 24/ 22
PRINT NAME: _Jose Acosta
Bulletin #100 — February 19, 2020 Page 1 of 2 k:AHandouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existiggfixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
no mechanical work
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
BOILERS
FURNACES
HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existin fixtures to remain.
BATHTUBS (or Tub/shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
no pluming work
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
lake heaven
lake heaven
7,000
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
RESIDENTIAL - 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 EXISTING PROPOSED TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# 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 AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application