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22-105069-Application-11.22.22CITY OF 'k PERMIT APPLICATION -- PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325 Federal ay 253-835-2607 + FAX 253-835-2609 + permitcenteffcityoffederalway.corn PERMIT NUMBER 9 Z- / O -5 Q - S F TARGET DATE 11/30/'1042 SITE ADDRESS "AVE SUITE/UNIT S 28E2,6 2- o S '�DEA/9 L U-6y wA 1'8®© PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL A TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT V-V L �T_ U_ /Ab6 I AJ r, ONE H i PROJECT DESCRIPTION ) "'"� � /V� A Detailed description of work' to be included on this permit only rJd NAME PRIMARY PHONE e&y ^AI69 `2.06 SSE PROPERTY OWNER MAILING ADDRESS E-MAIL r _4ye ) rr� A oc can CITY ce - STATE wA ZIP 9 6c) 3 NAME PHONE A616) l.t; nJ E MAILLING ADDRESS y E-MAIL CONTRACTOR 2O C CITY Fatem STATE ZIP 9Fn" FAX w,6Lr wA WA STATE CONTRACTOR'S LICENSE & EXPIRATION DATE URI # NAME j ' 24^4 PRIMARY PHONE MAILING ADDRESS W" kt APPLICANT E-MAIL 2 s CITY F- STATE wA ZIP q8 FAX PROJECT CONTACT NAME _ /\) PRIMARY PHONE 7-03 �p i�-- (The individual to receive and MAILING ADDRESS - -7 E-MAIL , respond to all correspondence f % e AAA i y&4o concerning this application) CITY STATE FAX eI�ERA wA AQ&-;� 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 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 flied 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: T �� 11 / I�lJ�iv.-- DATE / 11 f 2-2- PRINT NAME: Bulletin #100 e February 19, 2020 Page 1 of 2 k:\Handouts\Pcrmit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing ixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (cntmnercial) BOILERS FURNACES HOT WATER TANKS grasy COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OFPLUMBING WORK PLUMBING PERMIT Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS (or Tvb/shower comb.) LAVS (band Sins) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS ixitchen/Utu¢y) WATER HEATERS (Etectric) 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 TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR ............. ...................................... ............................_.......... COVERED ENTRY DECK GARAGE G CARPORT I, ................. ........__.......... .......... ........................ ............... _. .. .._........... ...... .... 1 OTHER (describe) ........................ .................... .............. .................. ... ............. Area Totals EXISTING PROPOSED TOTAL **Jw" RONMi ONLY** ESTIMATED SELLING PRICE # OF BEDROOMS COMMERCIAL - NEW/ADDITION AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information NNW 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 PR03ECT AREA ONLY Bulletin #100 February 19, 2020 Page 2 of 2 k:AIlandouts\Permit Application