21-103630-Building Permit Application-08-30-2021-V1i
PERMIT NUMBER
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
TARGET DATE 9/15/2021
SITE ADDRESS
SUITE/UNIT #
30621 4th PL S, Federal Way, WA 9800
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 1000.00
-
TYPE OF PERMIT
N BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Bedroom Addition
Addition of wall to separate study from kitchen. The study will be converted
PROJECT DESCRIPTION
Detailed description of work to
into a bedroom.
be included on this permit only
NAME
PRIMARY PHONE
Sultanu Checkole
702-477-9776
PROPERTY OWNER
MAILING ADDRESS
30621 4th PL S
E-MAIL
Checkole92@gmail.com
CITY
Federal Way
STATE
WA
ZIP
98003
NAME
Property Owner
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME Lab Kang
PRIMARY PH0NE
206-229-7202
MAILING ADDRESS
30621 4th PL S
E-MAIL
Labskang@gmail.com
APPLICANT
CITY
Federal Way
STATE
WA
ZIP
98003
FAX
PROJECT CONTACT
NAME
Applicant
PRIMARY PHONE
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19,27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 a part of this application.
SIGNATURE:
PRINT NAME:v`ab Kang
08-11-2021
Bulletin #100 — February 19, 2020 Page 1 of 2 k:AHandouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing tures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (eo an er a
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Indicate how many of each type offtxture
to be installed or relocated as
part of this project. Do not include existingfixtures 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 HIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
N/A
N/A
N/A
$ N/A
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
Adult Family Home
7350
❑ Yes a No
❑ Yes K No
COMMERCIAL — NEWADDITION
Area in
Construction
# of
AREA DESCRIPTION
Square Feet
Occupancy Group(s)
a
Stories
Additional Information
NEW BUILDING .
ADDITION
COMMERCIAL — REMODEUTENANT IMPROVEMENTS
Area in
Construction
# of
AREA DESCRIPTION
Square Feet
Occupancy Group(s)
Type
Stories
Additional Information
TENANT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:AHandouts\Permit Application