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18-102923RECEIVE® 0 3 PERMIT APPLICATION I CITY OF JUL 2018 PERMIT CENTER t 33325 8� Avenue South +Federal Way, WA 98003-6325 Federal Way CITY CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcente n cityoffederalway.com �) GOMMUNrrY DEVELOPMENT PERMIT NUMBER �( _ 1 ® 2 3 _ Cj I g Illy f � TARGET DATE SITE ADDRESS SUITE/UNIT # 55d 5W c,a►mPU5 Fes► PROJECT VALUATION ZONING --[ASSESSOR'S TAX/PARCEL # $ &01000 I z D q- U 3 TYPE OF PERMIT e BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT p?�n+kra- Lakes PROJECT DESCRIPTION Detailed description of work to a tni�l 5Q` b' � w'e&Y- { be included on this permit only NAME ^ � O ^ � r V� PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL CITY STATE ZIP NAME 1 PHONE LM; coom MAMTN DRES`iS G Q ti 0 � (l to l E-MAIL CONTRACTOR VTY#'V STATE mil'\� ZIPq" FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE # NAME /�` _ � PRIMARY PHONE MAILING �V �777�ADDRESS E-MAIL APPLICANT ` W gxlZIP STAT W ^� _ FAX PROJECT CONTACT NAME PRIMARY PHONE MAILING ADDRESS E-MAIL (The individual to receive and respond to all correspondence CITY STATE ZIP FAX concerning this application) PROJECT FINANCING NAME ❑ OWNER -FINANCED When value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE 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 application. SIGNATURE: �— DATE y PRINT NAME: Ste' ` A I -CW Bulletin #100 - January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application MECHANICAL PERMIT Is Indicate how many of each type offixture to be installed or relocated as part of this pr9ject. Do not include existinp fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial) BOILERS FURNACES HOT WATER TANKS (Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT Indicate how many of each type o /ixture to be installed or relocated as part of this project. Do not include existir�q fixtures to remain. BATHTUBS (or Tub/shower Combos LAYS (Hand sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (Kitchen/utility) WATER HEATERS (Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? 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 ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED I 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 Square Feet Occupancy Group(s) Construction a # of Stories Additional Information NEW BUILDING ADDITION COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 — January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application R ES V BM ITTE 1RT11ENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8`h Avenue South CITY ❑� `U" - =� ��18 �� Federal Way, WA 98003-6325 Federal 253-835-2607; Fax 253-835-2609 Way CfTY OF 1=E;DErRk WAY www,6t nft'cdcralWzV.com COMMUNITY DEVELOPMEW RESUBMI17AL INFORMATION This completed form MUS T accompany all resubmittals. '"Pleasenote.' Additional or revised plans ordocuments for an active project will not be accepted unless accompanied by this completed form. Mailed resubmittals that do not include this form or that do not contain the correct number of copies will be returned or discarded. You are encouraged to submit all items in person and to contact the Permit Counter prior to submitting ifyou are not sure about the number of copies required. " ANY CHANGES TO DRAWINGS MUST BE CLOUDED. Project Number: - C) - 00 - Project Name: W-�A�. Project Address:? `ate C71�+5 Project Contact: 3-714EPhone: 6 RESUBMITTED ITEMS: ** Always submit the same number of copies as required foryour initial application.** Resubmittal Requested by: (Stall Member) Letter Dated: OFFICE USE oN Y RESUB #.- Distribution Date: 7 j Ell F- De t/Div Name # Description Building Planning PW Fire Other Bulletin #129 —January 1, 2011 Page 1 of 1 k:\HandoutslResubmittal Information R E S U B ills I.tjTMENT OF COMMUNITY DEVELOPMENT SERVICES 33325 8`h Avenue South CITY OF Federal Way, WA 98003-6325 JUL 11 2018 253-835-2607; Fax 253-835-2609 Federal Way www.citvoffedcralway.com CfiY OF FEDERAL WAY COMMUNITY DEVELOPMENT RESUBMITTAL INFORMATION This completed form MUST accompany all resubmittals. "Pleasenote: Additional or revised plans or documents for an active project will not be accepted unless accompanied by this completed form. Mailed resubmittals that do not include this form or that do not contain the correct number of copies will be returned or discarded. You are encouraged to submit all items in person and to contact the Permit Counter prior to submitting ifyou are not sure about the number of copies required. ** ANYCHANGES TO DRAW/NGS MUST BE CLOUDED. Project Number: 0� CO _ � - Project Name: `RaInklaIr Project Address:) c� �� C�r� V�i lUr 'F V Project Contact: �1-G �Z Phone: RESUBMITTED ITEMS: # of Copies ** Detailed Description of Item Z 51�tct-fir '� 2U� '� SZUZ �oo�r�� 21rju w ** Always submit the same number of copies as required foryour initial application.** Resubmittal Requested by: (Staff Member) Letter Dated: /_ _/. OFFICE USE O%�OLT RESUB #.- Distribution Date: By. �2!�_ Dept/Div Name # Description Buildin Planning PW Fire Other Bulletin #129 —January 1, 2011 Page 1 of 1 k:\IIandouts\Resubmittal Information