22-100669-Building Permit Application-02-15-2022-V1CITY OF
Federal Way
PERMIT NUMBER _
PERMIT APPLICATION
PERMIT CENTER + 33325 811, Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
TARGET DATE
BITE ADDRESS
60(� �e
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SUITE/UNIT N
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL M
$ 3315-001-116
TYPE OF PERMIT
BUILDING PLUMBING MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
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PROJECT DESCRIPTIONReloaL
Detailed description of work to
A
be included on this permit only
NAME
& e o t /9• alwa
PRIMARY PHONE
5-11a - �i S -- O?311(
PROPERTY OWNER
MAILING ADDRESS
60(, 5. �'1�r,�i, ,leg �l�
EMAIL
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ZIP l W
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NAME �Q7 ens V /�/L�JD(S ,t ✓l C .G?
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MAILING ADDRESS 2
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CONTRACTOR
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CITY L/ii ✓i-,I ►i
STATE
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WA STATE^�,'TTr� WT 1945e1ENSE d
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EXPIRATION DATE ��
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6 of
793
NAME � � ��
PRIMARY
9 - 76?
MAILING ADDRESS
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E-MAIL
APPLICANT
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STATE /
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FAX
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NAME
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PRIMARY PHONE
pI5-3- q39- 76 R/
PROJECT CONTACT
Af
M"'L'"° "°D" Sf e �) �/0
3010
-L t i, @ fersgdtx � iti
(The individual to receive and
respond to all correspondence
CITY v / 0
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BTAT;1
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ZIP (
FAX
y^
concerning this application)
PROJECT FINANCING
NAME
OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27095)
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 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
part of this application.
SIGNATURE:
DATE
t eCl
10n
PRINT NAME:
C • Col
,LUW
U
Bulletin #100 - February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
)1 -5700
$
Indicate how many of each ttipe of
fixture to be installed or relocated as
part of this project. Do not include exist in cztures 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
y 300
$
Indicate how many of each tupe of
fixture to be installed or relocated as
part of this project. Do not include existing res to remain.
BATHTUBS (or Tub/Shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
_� RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Eieco-ic)
2
HOSE BIBBS
SUMPS
WASHING MACHINES
J TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
,V&
WATER PURVEYOR
-;),b(i
SEWER PURVEYOR
�v�i��
VALUE OF EMSTING IMPROVEMENTS
(-
EXISTING/PREVIOUS USE
'5l le F)im;
LOT SIZE (In Square Feet)
o?0 3Wd
EXISTING FIRE SPRINKLER SYSTEM?
-i Yes)< No
I
PROPOSED FIRE SUPPRESSION SYSTEM?
L 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 ❑ CARPORT ❑
............................................................................................................
OTHER (describe)
..........................................................................................................................
Area Totals E)aaTtNG PROPOSED TOTAL
"NEW ROAM ORLY"
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
—Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Groups)
Construction
a
# of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 - February 19, 2020 Page 2 of 2 kAHandouts\Permit Application