22-102249-Premit application-5-17-22A�
s
�^° d e
PERMIT NUMBER
PERMIT APPLICATION
PERMIT CENTER + 33325 8d, Avenue South + Federal Way, WA 98003 6325
253-835-2607 + PAX 253-835-2609 #
TARGET DATE I'lo
SITE ADDRESSS
SUITE/UNIT #
V® V �� \ W� Jy, V A (X)
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PA EL #
$ �A000
Q _�__ Q 0
TYPE OIL PERMIT
: 2fBUILDING KPLUMBING ICJ MECHANICAL ❑ DEMOLITION ❑ ENGINFERING ❑ FARE PREVENTION
NAME OF PROJECT
rft C C
YRUJEC;"L° UEkiC:Rll'7'1U1V
Detailed description of work to
ti r it -to A Yu b(AiAQ MOWA
V�iJ� 4
be included on this perrnit only
NAME
1 vi1 L ��
PRIMARY PHONE
I ?c� �—
PROPERTY OWNER
M LING�jADD SS
E-MAIL Y
8003
"A"'VA iced , I,i
PHONE
5`3 :So& 701fb
MAILINNG ADDRESS i
10 `1 " a� u
E-MAIL
/4CL' e jA
CONTRACTOR
cISTATE
ZIP
FAX
WA STATE CONTRAC R'S LI�CENSE # EXPIRATION DATE
UBI #
NAME'77) )q t
PRIMARY
MAILING ADDRESS
E- AIL
APPLICANT
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME
PRIMARY PHONE
1
-------- -------
"�
J
- ----
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
Wherz a,alue is ,9.5, Q00 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
T nort#R, .ind'or na 1#„ nF norh, that T — the #, F tho n —f— nrnnnr T -HA, *h�f *n tho ;cat
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
Wormation supplied to the city as apart of this application.
SIGNATURE: l y Uv Z. r'� DATE
jj jj-- - — - - -- -- - -- — ---
PRINT NAME: _ / / { �- l��
tt.
A&
Bulletin # 100 - February 19, 2020 Page 1 of 2 kAHandoutstPernut Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each typ+
AIR HANDLING UNIT i _
AIR CONDITIONER
BOILERS
COMPRESSORS
DU TING
PLUMBINC PERMIT
Indicate how many of each ttip:
BAT HVJBSI-1.a/Sh -ez-c.too)
DISHWASHERS
DRAINS
DRINKING FOUNTAINS
- HOSE HIBBS
to be installed or relocated as
PANS _
FIREPLACE INSERTS _
FURNACES
GAS LOCI. SETS
GAS PIPING
) jrxture to be installed or relocated as
I.AVS (11nnd Sinks) _
RAINWATER SYSTEMS _
SHOWERS _
_ SINKS (a4tr n/uc;tm^3
SUMPS
f this project. Do not include
GAS PIPE OEFFLETS
HOODS (Gbmm d.1) _
HOT WATER TANKS Ian}
REFRIGERATION SYST
WOODSTOVES
rf this project. Do not in
TOILETS
URINALS
VACUUM BREAKERS
WATER HEATERS
WASHING MACHINES
g� fixtures to remain,
tffHER (Describe)
VALUE; OF PLUMBING WORK
s 3 600
lude existing fixtures to ren
_ WATER PIPING
OTHER (Describe)
TOTAL FIXTURES
GENERA[, INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR.
SMMRPURVEYOR
VALUE OF XE/�[S\2WGIMPROVEMENTS
$ �' V0C Q` / W
EXISTINGIPREVIOUS"USE
LOT SIZE (in Square Feetl
EXISTING FIRS SPRINKLER SYSTEM? -
,PROPOSED FIRE SUPPRESSION SYSTEMY
i
LL Yes, -No
❑ Yes /"No
RESIDENTIAL - NEW OR ADDITION AREA DFESCRIPTION jin square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR (or Mobile Home)
I v
V"�
f
1
__..... .. _... _._ ... ._
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE 0 CARPORT El
OTHER (describe)
—
A tea Totals
�x sTuta
� aorasEb
ra roc
------- — _ - - --- - ----------------
**NEW BOMBS OM Y**
ESTIMATED SELLING PRICE $
1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Starnes
Additional Information
NEW 13UILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
'Construction
a
# of
Stories
Additional Information
TO TAT, BUILDING
TENANT AREA ONLY
E:Pio:,jiCTAREA ONLY
-T
Bidletin #100 - February 19,, 2020 Page 2 of 2 - kAllandoutsTennit. App ication