21-103962-Building Permit Application` PERMIT APPLICATION
CITY OF <`�
Fe d e ra I Way
CENTER + 33325 8' AVDt1UB South + Federal Way. Y4A 9AOI)3�25
253-835-2607 + FAX 253-835_2609 4pn� ![tninr .rat�riNNJ�/aFw / com
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TYPE OF PERMIT'
UILDING AUMBING MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTION
Detailed description of work to
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be included on this permit only
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PROPERTY OWNER
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CONTRACTOR
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APPLICANT
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PROJECT CONTACT
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(The individual to receive and
respond to all correspondence
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concerning this application)
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PROJECTFWANCING
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When value is S5, 0017 d more
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I certify under panalty of pwjury that I am the property owner or authorized agent of the prop"owner. I cwjfily Mgt to VW bast of my knowledge,
the Information submitted In supW of this permit application to truer and correct I certify thet I wtil rampty with aappticabte City of Fidar1d Way
regulations pertaining to the work authorized by the Issuance of a permit I undw stand there the issuance of M permit does not remove the owners
responslbiliry for compliance with focal, state, or federal laws regulating construction or anvlrunmentsl laws,
I further agree to hold harmless the City of Federal Way as to any claim rinchrdng costa, expenses, and attorneys' fees incurred in the Investigation
and defense of such claim), which may be made by any person, Including tit undoslpned, and fL%d against tit city, but orily whom such ciakn arises
out of the reliance of the city, Incfudi Its offlcers and employees, upon the accuracy of tit krfbrrnodon supplied to the city as it part of this
application.
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SIGNATUR DATE 9 IZpZ
PRINT NAME:
Bulletin # 100 - February 19, 2020 Page 1 of 2 Ullandouts\Permit Application
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MECHANICAL PERMIT
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Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existin
fixtures to remain.
AIR HANDLING UNITS
FANS �1
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODSCC-M-�
BOILERS
FURNACES
HOT WATER TANKS
— COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
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DUCTING
GAS PIPING
WOOOSTOVES
PLUMBING PERMIT
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Indicate how many of each type of fixture to be installed or relocated as pert of this project. Do not include exist! g fixtures to remain.
BATHTUBS,,,.,,—,.—,
LAVS n+.re`r.e
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
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OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
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DRINKING FOUNTAINS
SINKS i
WATER HEATERS ir�-kl
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
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❑Yes )t No
RESIDENTIAL -NEW OR ADDITION o itij} �
AREA DESCRIPTION (In square feet)
EXIST G
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Nome)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE C CARPORT ❑
OTHER (describe)
Area Totals
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"NEW HOMES ONLY"
ESTIMATED SELLING PRICE
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# OF BEDROOMS
COMMERCIAL - NEWIADDITION
AREA DESCRIPTION
Area In
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMM ERCIAL- REAIODEL/TENANT I N1 PROVENI ENTS
AREA DESCRIPTION
Area In
Square Feet
Occupancy Groups)
Construction
Type
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
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