21-101975-BuildingPermitApplication-06-18-2021-V11141&,
PERMIT APPLICATION
F
dera., I Way
PER,MITCF,NTER4,333258��Ave,rik,ae auth+T,�'edealWay,WA 8 j 98003-632,5
2��,>,,i835-2607+FINX253-83,S-2609+
PERMIT NUMBER
TARoET DATE ..... .... ..
SITE ADDRESS
-U1 TE —/U N IT
5+
PROJECT VALUATION
ZONING ASSESSOR'S TA] hiilli
$ 4so o0o
TYPE OF PERMIT
YkBL',11,11ING El PIAANUANU MEICHANICAL D'MOLV110N 1-1, I-L3 MRFPRf,..VK'NT10N
NAME OF PROJECT
7�
PROJECT DESCRIPTION
Deraded deswrij,)tion c1f woy* to
Ire included on this pernut on#ii
—iAILI�WATLPMSS
NAME FRIKARYPHONS
iLi
PROPERTY OWNER
E-MAM
6-
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7SF1;T9
CITY
FEW
Nord PTIONE
MAILING ADDRESS
CONTRACTOR
CITY TATE ZIP FAX,
WA STATE CONTRACTOWS LICENSE # EXIoRATION DATE USX #
Wi
L Wt
NAME PRIMARV PHONE
APPLICANT
MAILING ADDRESS
CITY
Id
PRIMARY P1107,8
PROJECT CONTACT
(The individual to reowh,,e and
KAILING AUDRESS E-MAIL
respond to all e,:,orr ".,, jxmdence
conrerrung this,
CITY FAX
Ir
PROJECT FINANCING
NAME OWNER -FINANCED
IL "hen vahse is $5,000 or Ynore
MAILINGADDRESS, CITY, STATE, ZIP 0xr
I certify under penalty of perjuril that I am theproperty owner or authorized tkqent of the property owner, I certify that to the best
of my knowledge, the inforatation submitted in support of this permit application is true and correct, I certify that I will coMply tuith
all applicable City of Federat Way regulations pertaining to the work authorized by the issuance of a permit, I understand that the
issuance of this permit does riot remove the ownera responsibility for:corm pliance with local, state, or federal laws regulathtit
construction or environmentat laws. Ifurther 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 bli arty person, including the undersigned, and filed against the city,
but on4y where such claim arises out of the reliance of the city, including its officers and employers, upon the accuracy of the
information supplied to the city as a part of this application,
SIGNATURE: DATE
PRINTNAME:
BLdletin 4100 - UebruarN 19, 2020 Page I U2 UllandoutsTerinit Applic-ation
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PLUNIBING PERMIT
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t° t�sClii
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DISHWASHERS RAMWATER SYSTEAIS
URINALS'
b ,'VrH PIPING
DRAM �CFC�a�C 1*�
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VACUUM 1IRRIAKERS
DRINKM3 t d UN % At v f nr .,,
CCE?S: R3C 3 iS
WATER RCS A« L € S a
su 4
WASHING, MACHINES
TOTALFIXTURES
B;.'Fti 1&TW�. S i?N i OP :* Tlii &£7. "kti's .bw
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ARFA DES Mf , (in square feet(. EXISTING
PROPOSED...
TOTAL FOR OPFICE USE
BASEMENT,
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Area Totals
PROMISED
TOTAL
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ESTIMATED SELLING PRICE $ )PBEDROOM
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COMMERCIAL- NEWADDITION
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ADDITION
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