22-102917RECEIVED
.
CITY OF
Federal Way
PERMIT APPLICA'T'ION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
COMMUNITY DDEVE OPMENT
JUN 14 2022
PERMIT NUMBER Cam` � _ / O ��` _.
CCCC����"� TARGET DATE
SITE ADDRESS
SUITE/UNIT #
31509 PACIFIC HWY S
PROJECT VALUATION
ZONING ASSESSOR'S TAX/PARCEL #
$4,000
v. -
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Pavilion Center - Grease Interceptor
Install (1) grease interceptor.
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
PRIMARY PHONE
KIR Federal Way 035, LLC
(425) 974-7570
PROPERTY OWNER
MAILING ADDRESS
�M�L
4065 Factoria Square Mall SE, Suite F-10
CITY
STATE
ZIP
Bellevue
WA
99006
NAME
PHONE
Hermanson Company
MAILING ADDRESS
E-MAIL
CONTRACTOR
1221 2nd Ave. N.
CITY
STATE
ZIP
FAX
Kent
WA
98032
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
HERMACL792NW
0911012023
602-004-844
NAME
PRIMARY PHONE
Lyndsi Foster/Hermanson Company
(206) 305-9238
MAILING ADDRESS
1221 tad Ave. N.
E-MAIL
lfo�tcr «Ircrmnnsen.coin
APPLICANT
CITY
STATE
ZIP
FAX
Kent
WA
98032
NAME
PRIMARY PHONE
PROJECT CONTACT
Lyndsi Foster
(206) 305-9238
MAILING ADDRESS
1221 2nd Ave. N.
E-MAIL
Ifoste ur( hermanson.com
(The individual to receive and
respond to all correspondence
concerning this application)
CITY STATE ZIP
FAX
Kent WA 98032
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(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! 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.
a,rn, wW atr�^w�.
Lyndsi Foster �'`A CHR.e�rtve,, W@er NccouMs
SIGNATURE: -'��0. % DATE „ 0 6/ 2 3/ 2 0 2 2
PRINT NAME: L V n d s l Foster
Bulletin #100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
MECHANICAL PERMIT
Indicate how many of each
AIR HANDLING UNITS
AIR CONDITIONER
BOILERS
COMPRESSORS
DUCTING
PLUMBING PERMIT
Indicate how many of each tqLl
BATHTUBS (or Tub/shower Combo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
to be installed or relocated as
FANS _
FIREPLACE INSERTS
FURNACES
GAS LOG SETS
GAS PIPING ^
fixture to be installed or relocated as
VALUE OF MECHANICAL WORK
this projecL Do not include existing tures to remain.
GAS PIPE OUTLETS OTHER (Describe)
HOODS (Commercial)
HOT WATER TANKS (Gas)
REFRIGERATION SYST
WOODSTOVES
VALUE OF PLUMBING WORK
$4, 000
Do not include existin.a fixtureS to remain
WATER PIPING
1 OTHER (Describe)
Grease Interceptor
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
y _
EXISTING/PREVIOUS USE LOT SIZE 1In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No ❑ Yes ❑ No
LAVS (Hand sinks)
TOILETS
RAINWATER SYSTEMS
URINALS
SHOWERS
VACUUM BREAKERS
SINKS (Kitchen/Utility)
WATER HEATERS (Electric)
SUMPS
WASHING MACHINES
RESIDENTIAL - NEW OR ADDITION
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
EXISTING
PROPOSED
TOTAL
"NEW HOMES ONLY''
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL. - NEW/ADDITION
AREA DESCRIPTION Area in Construction
S mare Feet Occupancy Group(s)
# of
Additional Information
Typa
Stories
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT .IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Group(s) s Construction
S uare Feet p y pl l
# of
Additional Information
Type
Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020, Page 2 of 2 k:\Handouts\Permit Application