21-101615RFCbaYED PERMIT APPLICATION
CITY OF �® 8/23/2021
CITY OF FEDERAL WAY PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way COb7MUNITYDF.\FLOPNIEST 253-835-2607 + FAX 253-835-2609 + pe=itcenter@cityoffederalway.com
PERMIT NUMBER 2 1
101615
SF TARGET DATE
SITE ADDRESS
SUITE/UNIT #
4417 SW 323rd ST Federal Way 98023
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 3,000.00
873202 0520
TYPE OF PERMIT
® BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Paustian Job
Remove existing window 94", Remove seperating wall 58 1/4", Remove seperating wall 341/8, Remove seperating wall 81 7/8
PROJECT DESCRIPTION
Detailed description of work to
All non -bearing walls. All walls located in the kitchen area.
be included on this permit only
NAME
Tony Paustian
PRIMARY PHONE
253.370.8157
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
4417 SW 323rd ST
CITY STATE
Federal Way WA
ZIP
98023
NAME
PHONE
Roma General Contractor LLC
206.561.5426
MAILING ADDRESS PO Box 1572
Ero.agcllc@oudookcom
CONTRACTOR
CITY Auburn
STATE
WA
ZIP
98071
FAX
WA STATE CONTRACTOR'S LICENSE #
ROMAGGC806BP
EXPIRATION DATE
1 l 17 12022
UBI #
604.565.654
NAME
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAD
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME Jessy Mayo
PRIMARY PHONE
206.351.3378
MAILING ADDRESS
Box 1572
E-MAILPO romagcllc@oudookcom
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Auburn
WA
98071
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 apart of this application.
03/26/2021
SIGNATURE: Jeaay I3faym DATE
PRINT NAME: Tessy Mayo
Bulletin #100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application