22-100028-COpermitapp1-5-22Olrfr
PERMIT APPLICATION
Federal
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NAME OF PROjg CT
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PROJECT DESCRIPTION
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NAME`
PROPERTY OWNER
CONTRACTOR
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APPLICANT
PROJECT CONTACT
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PROJECT CT PISANCING
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SAME PRIMARY 1,110fir
MAILPAX
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CITY —7;TATt, zip
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l +acrid, y Lander penalty afpefjury that 1 ton thin properly owner vt authorfitod ofivit of the pry rty varner; t rert(fq that to file Best
of nay knowledge, tho information ,submitted in support of'this permit application is true and correct, t carttfy that l will etunishi with
aalt appit€'aable Ofy of r odercal Way regulaattons pertaining to the auork authorized by the to ouaamcr of a permit. # untleraatun€l that tim
isstatnce of thfio permit roue not remove tho owner` responsibility for co prtartce With local, !starts, or frc#rrol acaw4 reilulatiny
awnstmetton or atanertrorers e"tal tarn c
l arthar agra* to hold hormtass the City of He4araal w"ny 00 to any claim jlnclual` AY costa. expense, and a attormsys',JOCA lnvurriot in
flea Yraaraetiyaitartt apart defense of such a:taainaj, which may be made liar any person, including the undersigned, axnd filod against ainst the city,
but Only whore such claim akritos out Of tier+ reldatraa°e of t#se city, tneluding its offierrs aatut arreptarpjars, xafat)n the taccuravy of the
information suppitrd to Afte city aas za part of this raplrttcaation,
SIGNATURE: DATr
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PLUMBING PERMIT
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VACUUMBREAXERS
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t'xi'SF' B!BBS SUMPS. ._.....�....... WASHINO MLAC st.1FS TOTAL r=URZs
GENERAL INFORNIATION
CR3TiGti iitFA.R ON PROPER", i'Pti S'Eii PS'FRV&Yt)R 9Et# it PiiRt YaF3 VALUE'UP "&S qNo TF§t'iFtt3'4ERSr�P'PS
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&XISTiTiG}F'REYItiia';x USE I l4G:"'iaZ i; (Zn :<quue F'eeCj i XiSTtIdi'i FIRE MUMMER SY^aT;~Ad } PRAPi;"ED FIR£ 8nPrRFS5ICi;ti `ia'.rw?
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AREA I7 SCRI TION (in square feet) MST'Ii G PRUF�fT + To TAL FOR OFFICE USE
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AWW ROMES ONLY,
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Area in Construction AREA DESCRIPTION 1 I Occupancy firoug(sj � � Additional Information
Square Feet Stories
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ADDITION
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ARIfPc DESCRIPTION Occupancy Crougts) i A:dditional Information
_ _ wuare Feet _ _. ___. _ _ _ ._ ? Stories + _
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iltilfefin #1Ctt7 -- Februan, 19, 2020 1 .42 (it 2 k: f hrn4fows flee Fit Appfivation