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Alk --I\/ E D CONSTRUMON PERMIT APPLICATION
CITY OF APPUCATION NUMBER*
Federal Way mAR 1 12-004 APPUCATION NUMBER.,
OTY OF FEDERAL`SAY APPLICATION NUMBER:
**The Poll oWl4alQuironibrmation — Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
Ass"so" A
■ PROJECT INFORMATION
PROJECT NAME-
■ PROJECT INFORMATION
DAYTIME PHONE:
IMM
APPLICANT: I NAME:
STATE, ZIP):
11
RELATIONSHIP R
Ei ARCHITECT o TENANT o OTHER( DESCRIBE):, 11 � I (
PHONE:
3ER:
CONTACT PERSON FOR THIS PR03ECT: 0 PROPERTY OWNER o APPLICANT tX CONTRACTOR �W
0 PROJECT INFORMATION
D(ISTING USE: EKISTING BUILDING ASSESSED/APPRAISED VALUATION
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS:
SPRINKLERED BUILDING? 9(YES El NO FIRE SUPPRESSION SYSTEM PROPOSEDIREQUIRED; C)AES 0 NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o TACOMA o PRIVATE (WELL) I
111
**NEW RESIDENTIAL CONSTRUCTION ONLY"
BEDROOMS:NUMBER OF
■ PROJECT FLOOR AREAS
.. IIIIII''IIII■■ • • . •
IN
► I
•
■ FIXTURES
MECHANICAL
Indicate number of each type of fixture
COMMUNM 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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