10-100015I n - l0 0 0
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CM OF
l way PERMIT
COMMUNITY DEVELOPMENT SERVICES APPLICATION253l-r8n3n5�a-2c6fi07i• FA253-835-2609
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1 1
PROPERTY
SITE ADDRESS
31720 Gateway Blvd. South Federal Way, WA 98003
SUITE/UNIT #
J ZONING ASSESSOR'S TAX/PARCEL #
PRO ACT
_
NAME OF PROJECT
(Tenant or Homeowner Name)4y p
❑ BUILDING u ❑ PLUMBING ❑ MECHANICAL
TYPE OF PERMIT
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
rc e_(
PEOPLE
NAME
PRIMARY PHONE
PROPERTY OWNER
Royal Hospitality, LLC
(503) 607 _1700
MAILING ADDRESS, CITY, STATE, ZIP 8 2 5 Cj 15 4 th Ave SE
E-MAIL
Newcastle, WA 98059
OWNER IS ALSO:
❑ CONTRACTOR APPLICANT ❑ PROJECT CONTACT
NAME Tricom Communications Inc
PRIMARY PHONE
( 702) 383 -2800
MAILING ADDRESS, CITY, STATE, ZIP 3540 West Sahara Ave
Las Vegas, NV 89102
FAX
(702) 383 -2806
CUNTPOR
WA STA.74 CONTRACTOR'S LICENSE A
EXPIRATION DATE
FE AY BUSINESS LICENSE #
NAME
Tricom Communications Inc
PRIMARY PHONE
383 2800
APPLICANT
(702)
MAILING ADDRESS, CITY, STATE, ZIP
FAX
2540 West Sahara Ave Las Vegas, NV 89102
(702) 383 _2806
PROJECT CONTACT
(The individual to receive and
NAME
Jeff Jessop Jr. 1�
J C. l) -
PRIMARY PHONE
702 383 -2800
( )
MAILING ADDRESS, CITY, STATE, ZIP
3540 West Sahara Ave, las Vegas, NV 89102
FAX
( 702) 383 _ 2806
respond to all correspondence
concerning this application)
ALTERNATE CONTACT NAME:
Tilton Johnson
PRIMARY PHONE
(702 ) 383 _2800
E-MAIL
tcsinc@reslv.com
PROJECT FINANCING
[[ QWNER-FINANC
Required for projects with
MAILING ADDRESS, CITY, S TS 2
PRIMARY PHONE
value of $5,000 or more
(RCW 19.27.095)
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 applica 'orL
r"
1
SIGNATURE: DATE
PRINT NAME:
Bulletin #100 - 4/21/2009 Page 1 of 4 k:\Handouts\Permit Application
e � +
MECHANICAL FIXTURES
Value o Mechanical Work $ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number o/'each type
offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS
FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS HOODS (commcrciai)
BOILERS
FURNACES HOT WATER TANKS (Gas)
COMPRESSORS
GAS LOG SETS REFRIGERATION SYST
DUCTING
GAS PIPING WOODSTOVES
PLUMBING
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS (orl)lb/ShowcrCombo)
LAVS (Hand Sinks)
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kpnhcn/utility)
WATER HEATERS (E)cctltc)
HOSE BIBBS
SUMPS
WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
to Yes ❑ No
RESIDENTIAL
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals E%13TDVG PROPOSED TOTAL
—NEW HOMES ONLY —
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area
in Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL _- REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION Area T Construction # of
in Square Feet Occupancy Group(s) Type Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — 4/21 /2009 Page 2 of 4 k:\IIandouts\Permit Application