22-102434-Permit Application-5.25.2022CITY OF
Federal Way
PERMIT NUMBER _
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2007 + FAX 253-835-2609 + permttcente u,cityoffederalway.com
TARGET DATE
SITE ADDRESS
SUITE/UNIT
PROJECT VALUATION
$3465
ZONING
1: �.
ASSESSOR'S TAX)PARCEL 4 d 1
AL� Z 2 7 0--�C, 0 0
TYPE OF PERMIT
E BUILDING ❑ PLUMBING ❑ MECIIANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
ZZ V 1 S 2 q l5j
PROJECT DESCRIPTION
Detailed description of work to
T n ,oi rd S GOn ✓ � 1 n SF Ali
"I G Garl r b
be included on thispermit only
PROPERTY OWNER
NAME
Cf Alr i 0� v `v
P YPHONE
2 - 5GI `306g
MAILING ADDRESS l
2 _ej7,00
MAU'
CITY
d e,d �✓�'
STATE
W
ZIP
� �
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE M
EXPIRATION DATE
U371 1
N E
PRIMARYPHONE
MAILING ADDRESS
lL j
APPLICANT
ICIT(Y( ,(]
L K� FG(e fr1 C,—
E ZIP
FAX
PROJECT CONTACT
HAKE
I_�4tn
PRIMARY PHONE
M'vLING ADDRESS
E-MAIL
rrhe individual to receive and
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
PROJECT FINANCING
NAME
Id OWNER -FINANCED
When value is $5,000 or more
tRCW 19.27095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perfury 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 rinetuding 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 a part of this application.
y
SIGNATURE: DATE Q S / � _/�� /' 2,
y
PRINT NAME: r1 k4,. f erll U ,y
Bulletin #100 —February 19. 2020 Page I oft kailandoutsWermit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Is
Indicate how many o each type o
ture to be installed or relocated as
part of this project. Do not include existing rwtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS OTHER IDescribe)
hey,;~
AIR CONDITIONER
FIREPLACE INSERTS
ItOODSlcamm wl P-L• e
BOILERS
FURNACES
HOT WATER TANKS (u.1
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
VALUE ORPwAWIN0 WORK
PLUMBING PERMIT Is
Indicate how many o each tl e gLfixture
to be installed or relocated as part of this project. Do not include existing tares to remauL
BATHTUBS 10rT4b/Sh-11C.."
LAVS IH—dsinkq
TOILETS WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (V kh—jUriGryj
WATER HEATERS (rk�t i l
HOSE BIBBS
SUMPS
I WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE Or EXISTING IMPROVEMENTS
N/A
EXISTING/PREVIOUS USE
S F f-
LOT SIZE 11n Squ— Feot)
7 210
EXISTING FIRE SPRINELER SYSTEM?
❑ Yes a/ No
PROPOSED FIRE SUPPRESSION SYSTEM?
c Yes ml No
RESIDENTIAL - NI:\N' oil 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.IIHT",
PROPOSED
TOTN,
**NEW HOLIES ONLY*"
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
ff Stories ofAdditional
Information
NEw BUILDING
ADDITION
COMMERCIAL — REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area In
S uare Feet
Occupancy Group(s)
Construction
Type
q of
Stories
Additional Information
TOTAL BUILDING
TENANT AREA ONLY
I.
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 kAlHandoutslPermit Application