22-100299-Building Permit Application 01-24-2022-V1PERMIT APPLICATION
CITY O
PERMIT CENTER $ 33325 8�' Avenue South +"Federal Way, WA 98003-6325
Federal Way253-835-2607 + FAX 253-835-2609 + permitcenter cityoffederalway.com
PERMIT NUMBER _
_ TARGET DATE
SITE ADDRESS ..
CYR
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL # 0
®.
TYPE OF PERMIT
>rBUILDING XPLUMBING >CMECHANICAL ❑ DEMOLITION CI ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
n PlAf> a i
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAMED--
0
PRIMARY PHONE
1 LIM '
MAILING ADDRESS :
E-MAIL
;.
% V or
PROPERTY OWNER -
e
CITY
Jr
STATE I
ZIP
NAME
PHONE
AILING ADDRESS t
t
E- IL ,
y
CONTRACTOR
CITY
STATE
:ZIP
FAX m
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
�:: �.
URI #
:ter a
NAME ' :.
5 - )1 G
PRIMARY PHONE
ry
MA%L% ADDRESS
E-MAIL
APPLICANT
CITY . ^s, f
S_ Te}TE
SF
ZIP
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NAME
[ I�
PRIMARY PHONE -
PROJECT CONTACT
MAILING ADDRESS gg
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:E-MAIL
rS"1"1"1 - jf�y co
The individual to receive and
respond to all correspondence
concerning this application)
CITY : }{�6
pSTATE
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V
ZIP ".
Y,„.,.
FAX V.
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PROJECT FINANCING
NAME r
OWNER -FINANCED
Whenvalue is $5,000 or more
MAILING ADDRESS, CITY, :STATE, .ZIP
PHONE
(RCW 19.27.095)
I certify under penalty of that 1 am the property owner or authorized agent of the property owner. I certify that to the best
,perjury
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 def, of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such cl im rises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the c ty as apart of this application.
DATE
SIGNATURE:
PRINT NAME:
Bulletin #100 — February 19, 2020 " k:\Handouts\Permit Application
MECHANICAL PERMIT
VALUE OF MECHANICAL WORK
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas) , 7
COMPRESSORS GAS LOG SETS REFRIGERATION SYSfi ) ) ti,,
DUCTING GAS PIPING WOODSTOVES
L UM13INO�PERMIT
VALUE OF PLUMBING WORK
Indicate how manyof each type e offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tuff%showerC—bo) LAYS (Handsi.ks) TOILETS :
DISHWASHERS - RAINWATER SYSTEMS URINALS
DRAINS' SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS (Kitch-xtiiity) WATER HEATERS (Electric)
HOSE BIBBS SUMPS WASHING MACHINES
WATER PIPING
OTHER (Describe)
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON.. PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTINGIPREVIOUS USE -
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?:
c Yes ❑ No
-PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
.RESIDENTIAL ® NEW OR ADDITION
AREA DESCRIPTION (in square feet):
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT Y
.... . ... ..........
.. .....:.. ............. ............::
FIRST FLOOR (or Mobile Home)
............ .
SECOND FLOOR
.... .. .....
COVERED ENTRY
........ ........
."....
DECK
.................................................
.....::.:
GARAGE ❑ CARPORT ❑
... ...,.....
f
OTHER (des rib,)
Area Totals
ERTSTINO
PROPOSEO
TOTAL
"NEW HOMES
ONLY"
ESTIMATED SELLING PRICE $
# OF BEDROOMS
OMMERCIAL, — NEWADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
N W BUILDING
:ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Inforation
t
TOTAL BUILISING
TENANT AREA ONLY "
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 k:\Handouts\Pennit Application