22-100822-SF-Building Permit Application-02-24-2022 V1_� PERMIT APPLICATION
CITY OF �'
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way253-835-2607 + FAX 253-835-2609 + permitcentergacityoffederalway.com
PERMIT NUMBER 2 2 -10082 -SF_ _ _ _ _ _ -
- TARGET DATE
SITE ADDRESS
SUITE/UNIT #
3822 SW 321 st St. Federal Way, WA
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 13,289.07
—8731%-25Il0 -
TYPE OF PERMIT
((
y� BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
3822 SW 321 st St.
PROJECT DESCRIPTION
Detailed description of work to
Voluntary repair to existing foundation
be included on this permit only
NAME
PRIMARY PHONE
Jerry Howland
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
3822 SW 321 st St.
CITY
STATE
ZIP
Federal Way
WA
98023
NAME
PHONE
Ram Jack West
541-510-9079
MAILING ADDRESS
E-MAIL
PO Box 11701
CONTRACTOR
CITY
STATE
ZIP
FAX
Eugene 7OR
97440
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
RAMJAW*852PW
4 / 30 / 2022
603499720
NAME
PRIMARY PHONE
Rebecca Ferren
541-510-9079
APPLICANT
MAILING ADDRESS
PO Box 11701
E-MAIL
permits@ramjackwest.com
CITY
STATE
ZIP
FAX
Eugene
OR
97440
NAME
PRIMARY PHONE
PROJECT CONTACT
Rebecca Ferren
541-510-9079
MAILING ADDRESS
PO Box 11701
E-MAIL
permits@ramjackwest.com
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
Eugene
�OR
97440
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.
SIGNATURE: DATE 02/24/2022
PRINT NAME: —Cq rl P 4 eqvos
Bulletin #100 — February 19, 2020 Page 1 of 2 k:AHandouts\Pennit Application
MECHANICAL ANICAL E IT
Indicate how many of each type o fixture to be installed or relocated as part of this r*ct. 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)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
I
Indicate how many of each (tjpe offixture
to be installed or relocated as
part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/shower combo)
LAVS (Hand sinks)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
ICOMMERCIAL - NEWADDITION
AREA DESCRIPTION
Area in
Occupancy Group(s)
Construction
# of
Additional Information
Square Feet
a
Stories
NEW BUILDING,
ADDITION
COMMERCIAL - E EL/ ENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Occupancy Group(s)
Construction
# of
Additional Information
Square Feet
Type
Stories
TENANT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:AHandouts\Pennit Application