06-103431CITY OF
Federal Way
COMMUNITY DEVELOPMENT SERVICES
33325 8TH AVENUE SOUTH • PO BOX 9718
FEDERAL WAY, WA 98063-9718
253-835-2607• FAX 253-835-2609
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RECENF-PERMIT
DEC 2APPLICATION
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SITE ADDRESS: 33645 20th Ave. So. Federal Way SUITE/UNIT #: N/A
ASSESSOR'S TAX/PARCEL # 2121049004 (Parcel A) LOT SIZE (sj): 44.2 acres
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1): Please see attached.
(Attach separate page for lengthy legal description)
PROJECT•' •
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ELECTRICAL ❑ ENGINEERING X FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
Install wet sprinkler heads throughout for TI in sanctuary/school auditorium building.
(Sanctuary Building Permit Reference #04-101357-00-CO)
PROJECT NAME (Name of Business or Owner Last Name): Christian Faith Center
PEOPLE•• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
NAME PRIMARY PHONE
Christian Faith Center 206-870-3585 (Ellen)
MAILING ADDRESS CITY, STATE, ZIP E-Mail: ellenk@caseytreat.com
PO Box 98600 Sf_
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
McKinstry Company, LLC
Judy McClellan
206-571-1520
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
5005 3rd Ave. S.
Seattle, WA 98134
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
E-Mail Address
19-60-000003-00-BL
12/31 /06
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION DATE
MCKINCL942DW
3/16/08
COMPANY NAME
APPLICANT NAME
OFFICEPHONE
Abbey Road Group
Gil Hulsmann (Agent)
253-446-3510
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
PO Box 207
Puyallup, WA 98371
253-377-4265
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant X Agent ❑ Other (Describe)
253-446-3519
NAME PRIMARY PHONE E-MAIL ADDRESS
Toni Re 253-446-3516 tonir@abbeyroadgoup.com
Per RCW 19,27.095; Lender information is
NAME
required (fproject value, exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING USE N/A PROPOSED USE: School Auditorium/Sanctuary Building
EXISTING ASSESSED/APPRAISED VALUE $ N/A VALUE OF PROPOSED WORK $�'i �'i'i D09• 00
SPRINKLERED BUILDING? X YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? X YES ❑ NO
WATER SERVICE PROVIDER X LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER X LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)
t'
AREA DESCRIPTION
EXISTING
S . FT.
PROPOSED
S . FT.
TOTAL
S . FT.
BASEMENT
N/A
FIRST
N/A
SECOND
N,/A
THIRD
N/A
FOURTH
N/A
ADDITIONAL FLOORS (DESCRIBE)
N/A
DECK(COVERED?)
N/A
GARAGE ❑ CARPORT ❑
N/A
NUMBER OF FLOORS
EXISTING
PROPOSED
TOTAL
OTAL EXISTING 9F
TOTAL PROPOSED 9F
TOTAL 9F
"NEWHOMES ONLY" NUMBER OF BEDROOMS AZA IMATED SELLING PRICE $ N/A
Indicate number of each type offixture to be installed 4r relocaLod as part of- ribs project. Do not include existingfixtures to remain.
MECHANICAL: NIA
Value of Mechanical Work $
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMB12VG: N/A
BATHTUBS (or
GAS PIPE EIS
WASHI MACHINES
lil (Bathroom Sinks)
1EVAPORATWE COOLERS
FANS
FIREPLACE INSERTS
FURNACES
GAS PIPE OUTLETS
Combo) SHOWERS
SINKS
SUMPS
URINALS
VACUUM BREAKERS
GAS LOGS
HOODS (Commercial)
RANGES
GAS WATER HEATERS
WATER CLOSETS (Tollet)
DRINKING FOUNTAINS
RAINWATER SYST
HOSE BIBBS
ELECTRIC WATER HEATERS
REFRIG. SYSTEMS
WOODSTOVES
MISC (Describe)
MISC (Describe)
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 supplied to the city as a part of
this application.
NAME/TITLE .6U&D., Y ]H
(slgliai
RELATIONSHIP TO PROJECT
❑ Owner X Agent ❑ Contractor ❑ Architect ❑
FOR OFFICE USE ONLY
NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR X TENANT IMPROVEMENT
BUILDING SHELL ONLY?
-YES . NO
BASIC PLAN? : YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? ❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP/SEPA/SU? _. YES
-: NO
PLATTED LOT?
YES 7: NO
DEMO PERMIT REQUIRED? ❑ YES
❑ NO
Bulletin #100 — January 7, 2005 Page 2 of 4 k\Handouts\Permit Application