04-103830CONSTRUCTION PERMIT APPLICATION
CITY OF RECEIVED APPLICATION ) - �
Federal Way APPLICATION NUMBER:
SEP 2,1. Z004 APPLICA110N NUMBER:
**The following is required information — Please print (in ink) or type**
Please note: Electrical, Fire (ATL�#k��, "Ingineering permits may require a separate application.
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SITE ARESS: �� " �5� Commns ASSESSOR'S TAXIPARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
IN
TYPE OF PROJECT (This application): c BUILDING c PLUMBING c MECHANICAL c DEMOLITION
o ELECTRICAL o ENGINEERING NFIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Add 58 sprinkler heads
PROJECT NAME: PaC Shin
PROPERTY OWNER: NAME: Madison Marquette
MAILING ADDRESS (STREET ADDRESS; C[TY, STATE, ZIP):
401 Brqagwa'; Avenue E.� Sui
CONTRACTOR: NAME; Crown Fire Protection, Inc.
MAILING ADDRESS (STREET ADDRESS, , STATE, ZIP):
P.O. Box 12113 Mill Creek,,
CrTYOf FEDERAL WAY BUSINESS LIUME NUMBER:
(copy of card required)
APPLICANT: NAME: — SAME AS CONTRACTOR
_7WA_V_1NGADbREZ {STREETADDRESS; CITY, STATE, ZIP):
23 Seattle, WA
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DAYTIME PHONE'
DAYTIME PHONE
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( 425) 481 7669
EVENING PHONE:
FAX NUMBER:
EXPIRATION DATE:
L L
RELATIONSHIP TO PROJECT:
ARCHITECT❑ VENANT o OTHER ( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER o APPLICANT o CONTRACTOR
EVENING PHONE:
FAX NUMBER:
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EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED: c YES c3 NO
WATER SERVICE PROVIDER: c LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE (WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o PRIVATE (SEPTIC)
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**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE:
FLOOR EXISTING S . FT. PROPOSED S . FT. TOTAL
BASEMENT
FIRST
SECOND
THIR
D
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
_HOW MANY FLOORS?
TOTAL:
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILERS) FIREPLACE INSERTS) RANGE(S) MISC.
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHERS) RAINWATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINKS) WATER CLOSET(S) MISC.
INTERCEPTORS) SUMP(S)
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information supplie the city as a part of this application.
NAME/TITLE: / DATE:
❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR
....e .....�..� ..ter ....� . .
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION: BUILDING SHELL ONLY? ❑ YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS RE UIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718 • 253-661-4000 • FAX: 253-661-4129
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