21-103775 - Lucky Child Care Application 11.16.2021-;& PERMIT APPLICATION
CITY or el PERMIT CENTER + 33325 811' Avenue South + Federal Way, WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835.2609 + pernutcentertri;cityoffcderalway.com
PERMIT NUMBER 2 1 1 0 3 7 7 5- C O
— — — — — — — — — — — TARGET DATE 11/27/2021_
SITE ADDRESS 99003
SUITE/UNIT #
320201et Ave S, Federal Way,
STE 108
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL#
$6000
Geneml Group E, Type
1 7 _2_ __1 _O_ 4_ - _O_
1, Zone OP
TYPE OF PERMIT
XO BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIREPREVENTION
NAME OF PROJECT
Lucky Child Care bathroom expansion for ADA compliance
Lucky Child Care bathroom tenant improvement, combine with adjacent utility closet, enlarging
PROJECT DESCRIPTION
bathroom repositioning drain and toilet to make it ADA compliant
Detailed description ofuxlrk to
be included on this permit only
NAME
PRIMARY PHONE
TienHa
2067156612
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
11661 SE 1ST ST STE 205
Luckycbildcarecenter(a-;gmail.rom
CITY
STATEW
ZIP
Bellevue
A
98005
NAME
PHONE
TED GOING OUT FOR BIDS _
MAILING ADDRESS
E-MAIL
1 CONTRACTOR
CITY
STATE
ZIP
FAX
I
WA STATE CONTRACTOR'S LICENSE if
EXPIRATION DATE
UBI#
NAME
PRIMARY PHONE
Maryan Osman Ali
2066370358
MATING ADDRESS
E-MAIL
APPLICANT
11661 SE 1ST ST STE 205
Luckychildcarecenter'Sgmail.com
CITY
STATEW
ZIP
FAX
Federal Way
A
98003
NAME
PRIMARY PHONE
PROJECT CONTACT
DWIGHT LENTZ
2533043145
MAILING ADDRESS
26606 187rH AVE SE
E-MAIL
DWIGHTDAVIDLENTZu GMAI..COM
(The Individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
COVINGTON
WA
98042
PROJECT FINANCING
NAME MARYAN OSMAN ALI
X OWNER -FINANCED
When value is $5,000 orawre
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19,27,095)
32020 1ST AVE SOUTH STE 108 FEDERAL WAY WA 98003
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 cert(/y that I will comply with all
applicable City of Federal Way regulations pertaining to the work authorised 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 q/ficers and employees, upon the accuracy of the information
supplied to the city ps)a part of this application,
SIGNATURE:
Bulletin #100 —February 19, 2020
h
Page 1 of 2
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kAHandouts\Permit Anal
PRINT NAME: _MARYAN OSMAN ALIT / / C'/ I LYC04 4 h- 1
Bulletin #100 — February 19, 2020 Page 2 of 2
BFlandoutslPermit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
1$0.00
Indicate how manjiloreach tUpc of
fixture to be installed or relocated as
aart of this project. Do not include exist Lrtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (c mm mw)
BOILERS
FURNACES
HOT WATER TANKS (G-I
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
PLUMBING PERMIT 1 $3000.00
Indicate how mart-yofeachtypeoffixture to be installed or relocated as vart of this proiect. Do not include existing Ixtures to remain.
BATHTUBS (or7Ut,/Sh—Comn0) LAVS (H—dSlnlc+) X TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS (Kitchen/UHMY) WATER HEATERS (Elcetric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATERPURVEYOR
SEWERPURVEYOR
VALUE OF ERISTrNOIMPROVEMENTs
EXISTINGIPREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FME SUPPRESSION SYSTEM?
NET SPACE 201E SF, BUILDING
❑ Yes ❑�lY NO
❑ Yes ❑ "V`xNo
17460 SF, LOT 93069 SF, 21
RESIDENTIAL -NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
................. ............ .......... ...._.............. __.._............. _...
BASEMENT
N/A
.................
.............. ........ ................................ .... _._.._..... ............... _......... ...__...
FIRST FLOOR (orMobtleHome)
N/A
................ ..................... _... I ...... ..... _...._...__._
SECOND FLOOR
N/A
...........
COVERED ENTRY
N/A
... _................. ................................ ............ _...._.—...__ _
DECK
-
N/A
........ _....... _........................... .......... _............ __••-•-•-------.._...__
GARAGE ❑ CARPORT ❑
N/A
.......... ............ _............................... ... _.... ___.._.............__.................
OTHER (describe)
N/A
... ............. _................... _......... _._____.__...... _.__._.._.� ..l
Area Totals
EXISTING
PROPOSED
TOTAL
............ ... _............ ....................... .
'
**NEWHOMES ONLY**
ESTIMATED SELLING PRICE
A
I # OF BEDROOMS
COMMERCIAL— NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
N/A
ADDITION
COMMERCIAL — REMODEL/TENANT
IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construe on TypStories
Additional Information
TOTAL BUILDnrG
17560 SF
GROUP E
TYPE 2, 2 HRS
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 3 of 2
k:\I-Iandouts\Permit Application