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20-104392-Permit Application-11-15-20-V240k CITY OF PERMIT APPLICATION PERMIT CENTER + 33325 8f Avenue South + Federal Way, WA 98003-6325 Federal Way 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com PERMT NUMBER Z () - { b 1 � { Z c_-) 2- _ S . - � �./ L {� ImoTARGET DATE 9UITB/4IINIT # PROJECT VALUATION ZONING ASSESSOR'$ TAXIPARC TYPE OF PERMIT BUILDING ❑ PLUMBING Ej MECHANICAL ❑ DEMOLITION Lf ENGINEERING D FIRE PREVENTION NAME OF PROJECT V A C—:: 5S PROJECT DESCRIPTION r , C 4 T 5' yTZMPAL [ * } Q, 4 Detailed description of work to be included on this permit only S JV NAME MA PRIMARY PHONE fok 16q-- �;(o Z(P PROPERTY OWNER MAILING ADDRESS 2 7,* 219661 MVA oNE �3g7_f (900 Nf/;IyINCr ADDRESS �COf O `� '� �r E-MAIL CONTRACTOR �v�LJ ` W T18,1 VU FAX / /A 1.0,AAV&T'& WA STATE CONTRACTOR'S LICENSE # L 1-1( VV\ EXPIRATION DATE �� i 23 iZZ, UBI # 666 NAME P 71 C PHQ q I _(o R MAH.IN DRESS �r(((]ifiTM/u41SrK_J APPLICANT \�r3gqS YV r SLAM Z L7d Z PROJECT CONTACT NAME PRIM5Y PHONE ` (The individual to receive and respond to all correspondence m4,P FG ADDRESS i } _ ��*�� 1 � LA � CIMN F-ALilL eQQ1 e&& , TAT Z Q FAX concerning this application) PROJECT FINANCING NAME �.xl� b � � g ❑ OWNER -FINANCED When value is .$5,000 or mare (RCW 19.27.09.5) MAILING AD RESS, GI' , STATE, ZIP yy `` PHONE IV 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 apart of this application. SIGNATURE: 1 DATE PRINT NAME: I 'C i A -5 L`� I L U! t`- Bulletin 4100 - February 19, 2020 Page 1 of 2 k:IHandoutslPermit Application VALUE OF MECIIANICAL WORIf MECHANICAL PERMIT $ Indicate how mariny of eachTGAS e installed or relocated as art o this project. Do not include exis res to remain. AIR HANDLING UNITSAIR CONDITIONEREPLACE INSERTS HOODSBOILERSNACES HOT WATER TANKS (Gas) COMPRESSORS LOG SETS REFRIGERATION SYST DUCTING PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ I Q 4-L Indicate how many of each type of fficture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS (-T b/Sh.—C—be( LAVS gin dsmk.) TOILETS WATER PIPING ( _ DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAWS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (xitch—iUtuityl WATER HEATERS (gectricl HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS UMSTING/PREVIOUS USE LOT SIZE (Ln Squace Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSEJ) PIkE SUPPRESSION SYSTEM? Lg `i' o Yes © Yes YNo RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL BASEMENT -- FIRST FLOOR (or Mobile Home)O SECOND FLOOR`�— COVERED ENTRY- r DECK GARAGEN�,CARPORT L 2, c� OTHER (describe) ` �- �E PIeo= sm �rouu. Area Totals **NEW HOMES ONLY*° ESTIMATED SELLING PRICE $ # OF BEDROOMS _ FOR OFFICE USE COMMERCIAL - NEWIADDITION 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(a) Construction Type # of Stories Additional Information TOTAL BUILDING /v /A c TENANT ARFA ONLY PROJECT AREA ONLY Bulletin #100 - Febn=y 19, 2020 Page 2 of 2 k:lHandoutslPermit Application