21-102423-Building Permit Application-06-16-2021-V1CITY OF '`�e�c�e
Federal Way
PERMIT NUMBER
PERMIT APPLICATION
PERMIT CENTER + 33325 P Averitie Soutb + Fe&rid Wad , WA 98003-6325
253-835-2607 + MX 253-835-2609 + }zrtrlftcrra�N„r.t~ c�firder.tili.a; e�rrl
TARGET DATE
SITE ADDRESS
SDITS%UNIT
PROJECT VAFXATTiI/ON]
ZONING ASSESSOR'S TAX/PARML !
jQ/ f
2 //2
TYPE OF PERMIT
r] B(I)i.DIlia; 0 Pi-OMfiftti , C 1Mh 1tAiil€':AL � C} T :i.-lE -<< iJ i ii �,.d
NAME OF PROJECT i
1
�1:.Lrtr Z-- T 'EZ �
PROJECT DESCRIPTION
t7eladed descrplion of work to
I AJ I TO
be nictuded on this permit only
NAME
PRIMARY PHONE
I '
A u;k er'S GrouP GL C
2a6 -330
PROPERTY OWNER
MAu,ENG ADDRESS
F-MAIL
.2-57)5 5. 2ak� y4-- s-rE 6-70
!,Lj ivL e rS nra,1v �.
CITY �i !!
�L1 Qi%C+l L!/A
STATE
w,4
SIP 7
��kv,?
!9FC1-A rti.� i•raY�
NAME 1
lltiel\+1 �VVL'3�r(-JC'+;E)—, tLC
PHONE
2of, r v�1 i�S7i
MAILING ADDRESS
E-MAIL
CONTRACTOR
` C� Pcti . �• 4 �A LJ`(
CITY
STATE
ZIP
FAX
I
Ml�kvr<
WR
`1335`l
WA STATE CONTRACTOR'S LICENSE 3
EXPIRATION DATE
QSI 4
/AAA C ( L 960K11
zA /�OX:k
603 - 31gb - 50h
NAME
c L.Lr e,
PRIMARY PHONE
3• 0 - to7�
d1AILIN ADDRESS
Zq to C S
s-MAIL
-t mv-h4
APPLICANT
CITY' )
STATE
ZIP
PAX
NAME
�"
PRIMARY PHOIiE
7
PROJECT CONTACT
�-
MAiLMG ADDRESS
t
£-MAIL
1 tntfflr€dual to receive and
respond to all correspondence
CITY
STATE
I ZIP
FAX
concPmmg this applfC host)
f�
PROJECT FINANCING
NAME .9eLr l-- f� � ,1�
Q OWNER -FINANCED
iV Ilt'n I w1ut, Is &S 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
-HONE
see',
[Igo W 'wtee� S k.
I certify under penalty of perjunry 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 uttorncys' 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 anly 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 Ofthis application.
SIGNATURE: ✓ Lt+•1 c*X� DATE i1 I6 j'A I
F
PRINT NAME: �. S r n: l olrz-..tk.�__
Bufletin9100--Fchruarn I9,2020 Page Iof2 k'ilLuldozlti�i�cTnut.Al+plieallola
^
VALUE OF MECHAMCAL WORK
MECHANICAL PERMIT
$ or, 00c-)
Indicate how many of each type o
re to be installed or relocated as
part of this project. Do not include existing rxtures to remain.
i AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
J_ AIR CONDITIONER
FIREPLACE INSERTS
HOODS (Camaitrciai)
BOILERS
FURNACES
_ HOT WATER TANKS )Gas)
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
� GAS PIPING
WOODSTOVES
VALUE OF PLUMI3BVG WORK
PLUMBING PERMIT
_,_ BATI-ITUAS forT b(Shawcrc._i�} !� LAYS {H—dSink.) _ ' TOILETS _j WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS jutch—jutitity) WATER HEATERS I ca c}
Z HOSE BIBBS SUMPS �_ WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATERPURVEYOR
SEWER PURVEYOR
VALUE OF $)FISTING IMPROVEMENTS
j� 1 Ae
twrr_ il'r'040&A
t A4,,, gr 14 wa
$ �Gt
]EX1[STINO/PREVIOUS USE
LOT SIZE {In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
✓�� T
.4 9
Ei Yes')e No
--I Yes ). No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
rOUSTiN'G
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
Q
FIRST FLOOR (or Mobile Home)
0
SECOND FLOOR
_7 ra
0
COVERED ENTRY
D
QO
DECK
4
p
GARAGE '5it CARPORT ❑
D
?0 &
706c,
OTHER (describe]
LID
1-7-7
1-7-7
-
Area Totals
E7IISMG
PROPOSIM
TOTAL
q
__....._................. ............ ... .._ _.. -
**NEW HOMES ONLY"
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL — NEw/ADDITION
AREA DESCRIPTION
Area In
Square Feet
Occupancy Groups)
Construction
a
# of
Stories
Additional Information
Nxff EU'IiAtINNCx
ADn1'I`I6N
COMMERCIAL -- REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL BMLDING
TENANT AREA ONLY
PRO3ECT AREA ONLY
Bulletin #100 —February 19, 2020 Page 2 of 2 k:lHandoutslPermit Application