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21-103931-Building Permit Application-09-27-2021-V11�k CITY OF Federal Way PERMIT NUMBER PERMIT APPLICATION PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permitcentei A cityofl'ederalway.com — TARGET DATE ` ( ! ;;,L'>_� SITE ADDRESS SUITE/UNIT # �o ,f a F6 -�ti /V/ 1 PROJECT VA�LyJUATION ZONIINGASSESSOR'S TAX/PARCEL # c10 Q� 4s- � 6 O TYPE OF PERMIT !� BFIRE PREVENTION UILDING 1-1PLUMBING 1-1MEECHANICAL ❑l DEMOLITION ❑/ENGIIN�E/ERING ❑ NAME OF PROJECTd �I V�' y`,� �JP I go+i1 /"/ ,4'�l/0�(�i'/( ?b �%d/�d✓1 / �pDr�l PROJECT DESCRIPTION Detailed description of work to �'�� Q t' % Pam^ f C(L° G(J / Lf1TeO1170001r Qpl -r;X 4CLUZ ZZ 6q4hP-&QAWj be included on this permit only PROPERTY OWNER NAME ��-- oiaf u/�" /�a�vla PRIMARY PHONE 20 `%5-- — 4��� MAILING ADDRESS / �e> C16 Z h r, E-MAIL CITY �� STATE yW'' ZIP 80� NAME _1�1r�jmqf J 1.W q_ A, PHONE MAILING ADDRESS E-MAIL CONTRACTOR C(���iC / e Olt- ro l wa 31 Al /j�-T W ZIP_SO0� (7EEXPIRATION FAX WA STATE CONTRACTOR'S LICENSE # DATE UBI # NAME/ Cl �G{ RIMA11Y PHONE H t/ U MAILING ADDRESS I 2,f,2 bclrA %;44- Po/ E-MAIL APPLICANT CITY I ZLca'�rir1 STA ZIP G1/� ©D FAX PROJECT CONTACT N9� / / / Cr 7l'Q y!°I '(� PRIMARY ONE /f aO+�I MAILING ADDRESSS� l //Rl ©lo? 74 4_� E-MAIL (The individual to receive and respond to all correspondence CIT STATE ZIIP} NAME FAX concerning this application) PROJECT FINANCING Er OWNER -FINANCED When value is $b, 000 or more (RCW ] 9.27.095) MAILING ADDRESS, CITY, STATE, ZIP PHONE 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: DATE ..� PRINT NAME: Bulletin # 100 - February 19, 2020 Page i of 2 k:\Handouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ v Indicate how nmn_q of each type a rxlure to be installed or relocated as part of this project, Do not include exisfingfwfures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial) BOILERS FURNACES HOT WATER TANKS (Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ C 00 Indicate how MgM of each type offidure to be installed or relocated as eart of this ra ed, Do not include exisi trig res to remain. BATHTUBS (or Tub/Shower combo) _ LAVS (Hand su, ,) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING 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 d 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 BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER (describe) Area Totals EXISTING **AWW gams ONLY" ESTIMATED SELLING PRICE PROPOSED I TOTAL I FOR OFFICE USE PROPOSED # OF BEDROOMS TOTAL COMMERCIAL — NEW/ADDITION AREA DESCRIPTION Area in Square Fcct Occupancy Group(s) Construction 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:\Handouts\Permit Application