22-105688-Application-12.19.22PERMIT APPLICATION
CITY OF 4§�
PERMIT CENTER + 33325 81" Avenue South + Federal Way, WA 98003-6325
Federal Way253-835-2607 + FAX 253-835-2609 + permitcentex@cityoffederalway.com
PERMIT NUMBER _ _ ) D -;3-? -- � t��
_ TARGET DATE
1 SITE ADDRESS SUITE/UNIT #
#.203 Sw �8'�Z. S+ er�l Gt/ vIJA o18023
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL #
$ /6no.o6) :1 S '1 3 2 C
TYPE OF PERMIT
V BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT Add h BeGImow? 6
Co-1per41Y7. 01 lur G room in �-GtR b�tser►'ient in }a
PROJECT DESCRIPTION
description of work to
.rwo ✓0 , . �1✓! ohe �l�e i� Nll�� %C a 11
rldo� C.Detailed
pond 44L oW4v owl C will of of rvni i! room
be included on this permit only
a- a'-k lb" ,, etA, Dim :)L si?,L�
NAME
isxlQa1r no c vl
PRIMARY PHONE
a53 63a-05'+'�
PROPERTY OWNER MAILING ADDRESS
1 i005 5E 3o�'' 64
E-MAIL
r9011a:egr WAQ;1.
CITY STATE ZIP
"L4r10 WA. °►�Uq2
�.��'1
PHONE
_
NAME
MAILING ADD RE S
E-MAIL
o1s ;Xove.
CONTRACTOR
FAX
CITY STATE ZIP
WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE
UBI #
--- - - - - -
NAMEi==� �v>oVF�R1i
PRIMARY PHONE
APPLICANT
MAILING ADDRESS ��a j I 1
13205 S� v'l ce r
E-MAIL
clw I Nro
STATE
IW1 A
ZIP A
V
FAX
NAME
* j
�` • �ar 6'r
PRIMARY PHONE
PROJECT CONTACT'
"-+r/` 1v
MAILING ADDRESS e
V
� r
(The individual to receive and
respond to all correspondence
CITY
STATE ZIP
.FAX
concerning this application)
PROJECT FINANCING
NAME
ndrq rd .
OWNER -FINANCED
When value is 000 or more
(RCW 19.27095)
MAILINGSS, CITY, TATE, ZIP
IV--�&15 SrSO+Vl-
` •3, �—_PHONE
Z
Bulletin #100 —February 19, 2020 Page 1 of 2 kAHandouts\Permit Application
MECHANICAL PERMITALUE OF MECHANICAL WORK
AlN1.19 $
Indicate how mane of each type o vcture to be installed or relocated as part of this jiMlect. Do not includ6existingftxtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commerciai)
BOILERS FURNACES HOT WATER TANKS
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
VALUE OF PLUMBING WORK
Indicate how man o each type offixture to be installed or relocated as
part of this pnqLect, Do not include; exist&v fixtures to remain.
BATHTUBS (or Tub/shower combo)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
HOSE BIBBS
LAVS (Hand Sinks(
RAINWATER SYSTEMS
SHOWERS
SINKS (Kitchen/Utility)
SUMPS
TOILETS WATER PIPING
URINALS OTHER (Describe)
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
N J9
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXSTING FIRE SPRINKLER SYSTEM?
❑ Yes ❑ No
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
.... -- ......... _.._._
............. �._
FIRST FLOOR (or Mobile Home)
e �
/ 7
$•�$ ,
?Z16.9,912
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
._..
••----................... _......... _........................ ........
_
Area Totals s
e4om
�0616t1
beTerg$
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Group(s)
Construction
lypOccupancy
a
# 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