21-102333-Building permit Application-06-10-2021-V1CITY OF - —•
Federal Way
PERMIT APPLICATION
PERMIT CENTER + 33325 80, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER _ _
TARGET DATE
SITE ADDRESS SUITE/UNIT M
313xx 10th ave SW Federal Way, WA 98023
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL N
600,000 7200residential 0 7 2 1 0 4 9 2 4 9
—
TYPE OF PERMIT ?/1BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT Grib Residential I
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
Residential home.
NAME Dina Grib
MAILING ADDRESS
35927 30th Ave S
CITY
Federal Wav
NAME
Six Star General Contracting
MAILING ADDRESS
CONTRACTOR 35927 30th Ave S
CITY Federal Way
WA STATE CONTRACTOR'S LICENSE 8
SIXSTSG812C6
NAME
Dina Grib
APPLICANT MAILING ADDRESS
35927 30th ave, S
CITY
Federal Way
NAME Dina Grib & Barb Ozanich
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
PROJECT FINANCING
When value is $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS 35927 30th ave S
CITY Federal Way
STATE I ZIP
WA 98003
STATE ZIP
WA 98003
EXPIRATION DATE
2 / 25 / ->�
STATE ZIPWA I 98003
STATE ZIP
WA 98003
NAME Dina Grib
MAILING ADDRESS, CITY, STATE, ZIP
35927 30th Ave, S Federal Way, WA 98003
PRIMARY PHONE
206-351-3464
i E-MAIL
dinagrib@hotmail.com
PHONE
206-351-3464
E-MAIL
dinagrib@hotmail.com
FAX
206-429-2217
Uses 604388351
PRIMARY PHONE
206-351-3464
E-MAIL dinagrib@hotmail.com
FAX 206-429-2217
PRIMARY PHONE
206-351-34641253-426-9436
E-MAIL
dinagrib@hotmail.com
FAX
206-429-2217
IrJ OWNER -FINANCED
PHONE
206-351-3464
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 o this application.
06/07/2021
SIGNATURE: DATE
Dina Grib
PRINT NAME: _
Bulletin #100 — February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $ 6,000
Indicate how marw of each typeoffixture to be installed or relocated asp art of thisproject. Do not include existingfixtures to remain.
AIR HANDLING UNITS 9 FANS 2 GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER _1 FIREPLACE INSERTS HOODS (commerciall
BOILERS —1 FURNACES 1 HOT WATER TANKS (cast
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
Indicate how manly of each tip e of
f m re to be installed or relol
4 BATHTUBS (or Tub/Shower Combo)
7 LAVS ([land sinks)
1 DISHWASHERS
RAINWATER SYSTEMS
DRAINS
2 SHOWERS
DRINKING FOUNTAINS
2 SINKS (kitchen/utility)
2 HOSE BIBBS
SUMPS
VALUE OF PLUMBING WORK
9,000
asp art of thisp ro)'ect. Do not include e
r TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS (Electric)
1 WASHING MACHINES 24
WATER PIPING
OTHER (Describe)
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
No Lakehaven Water & Sewer Dist. Lakehaven Water & Sewer Dist. 0
EXISTING/PREVIOUS USE LOT SIZE )In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
Vacant Lot 85,623 ❑ Yes ® No ❑ Yes as No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
BASEMENT
FIRST FLOOR (or Mobile Home)
2,276
SECOND FLOOR
2,404
COVERED ENTRY
90
DECK
84
GARAGE ® CARPORT ❑
1,175
OTHER (describe) Concrete Patio
218
Area Totals
EMSTMO
PROPOSED
6,247
Nf
TOTAL
IWAL
6,247
FOR OFFICE USE
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Groups)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS _
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:lHandouts\Permit Application