22-105551-Application-12.05.22RECEIVED
CITY OFVZN�61 o.M::°�F°�:E PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
PERMIT NUMBER 22 -,_1 0 5 5 5 1 - 0 0- SF
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
34665 10TH PL. SW, FEDERAL WAY, WA 98023
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 20,000
RS35.0
1 3 2 1 7 3- 0 4 8 0
TYPE OF PERMIT
*BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
JUNG PARK HOUSE REPAIR
REPAIR THE SMOKE AND WATER DAMAGED PORTION OF 1 ST
PROJECT DESCRIPTION
Detailed description of work to
FLOOR DUE TO FIRE.
Work also includes a new furnace
be included on this permit only
NAME
PRIMARY PHONE
JUNG PARK
PROPERTY OWNER
MAILING ADDRESS
34665 10TH PL. SW
E-MAIL
SK4411 DAUM.NET
CITY
FEDERAL WAY
STATE
WA
ZIP
98023
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME
FADRIAN HARTONO
PRIMARY PHONE
425-381-7558
MAILING ADDRESS
13782 NE 78TH PL
E-MAIL
FADRIANEGAJAYA@GMAIL.COM
APPLICANT
CITY
STATE
ZIP
FAX
FAX
REDMOND
WA
NAME
PRIMARY PHONE
PROJECT CONTACT
FADRIAN HARTONO
425-381-7558
MAILING ADDRESS
13782 NE 78TH PL
E-MAIL
FADRIANEGAJAYA@GMAIL.COM
(The individual to receive and
respond to all correspondence
REDMOND
WA
ZIP 98052NAME
FAX
concerning this application)
PROJECT FINANCING
JUNG PARK
• OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 1927.095)
34665 10TH PL. SW, FEDERAL WAY, WA 98023
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 apart of this application.
SIGNATURE: FH DATE 12.05.2022
PRINT NAME: FADRIAN HARTONO
Bulletin #100 — February 19, 2020 Page 1 of 2 k:AHandouts\Permit Application
22-105551
RECEIVED
Dec 06 2022
MECHANICAL PERMIT
pMMVX1ryOEVELOPeEXT
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include ex'
fixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (commercial)
BOILERS
1 FURNACES
HOT WAT KS (Gas)
COMPRESSORS
GAS LOG SETS
R ERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
VALUE OF PLUMBING WORK
PLUMBING PERMIT
$
Indicate how many of each type oLf4xtnfeto
be installed or relocated as
part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/shower co
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
ING 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 TOTAL
BASEMENT
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals EXISTING PROPOSED TOTAL
**NEW HOMES ONLY**
SELLING PRICE
# OF BEDROOMS
FOR OFFICE
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
Type
# of
Stories
A ,onal Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area Feet
Square F
O ancy Group(s)
Construction
Type
#
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PR AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application