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22-102394-SF-Building Permit Application-06-28-2022PERMIT APPLICATION PERlMfIT CENTER + 33325 8- Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-535-2609 + permitmeer@cityeffederalway.com c slr� tsi�i��sa surr�lr a PROJEL'Z VALUATION ZOIMG ASSE MWB TAXjPWX= f f - TYPE OF PERPM i I3UnZING ❑ PLurlslrlG ❑ MECHANICAL ❑ DFMOLMON © ENGIHEE^TNG ❑ FIRE PREVENY ON 1FAIy[E OF PROJECT 'P S;� GX A.p. ,64 it 1 •� w PROJECT DESCRIPTION iTefm7eti description of work to necLh 7�v - e/ be incheded on this permit only PROPERTY OWICER MA=G"1ntZ 8 7 14-v-e- - 4--.) M,?rk Qmbar ca NMy � 2 STATE q" G NAME PHONE 7mu m ADplZE95 g-IrrAu CONTRACTOR C1ZY SSATE ZIP p'A'Y a'A S TE CONTPACTORM LICENSE # EMPATION DAZE UEI 0 MMMY PHONE W -7 S- K&WNGADDRESS 29 d -i�j E-MAIL t fCL°t#2r3�'F`Lii�� Ec' APMCANT awe - c-i--- STATE w ZIP 2 FAX PROJECT CONTACT 6R � R �= i r PR 3L4jrr PEONS / - C fir— � .5 __ `7 l h !� isAELM ADDRESS 2- 17 E-MAIL Eli" P'he i ndii7i6iucai to remiue and respond m aU carrespondenm j J L �� er-&-m S>P PAY 3 concerning this n) � PROJECTFMASCTNO NAME Al a k--- lee Er OWNER-FMANCM When value is $5,000 or more pS MMG ADDRESS. Crnr, Gr"E, Zn+ PHONE (RCW 19.2T--D95} I certify raider pena[ty of perjury that I• am the property owner or awthorlaed agent o, f #sa proper•tg owner. Z certify that to the best of mg knowledge, tie irybratatton sainnitted in support of this permit application is true and Correct. I eer'to that I will comply rotfth a[i applicable City of Federal Way reguUrtions pertaining to the um* authorized by the issuance of a permit. I uaderstaud that the issuance of this permit does not rwmue the owner's responsibility for compliance with lom4 State, or federal taws regalattng corestracUon or cnutrarxrnental laws I further agree to hold harmless the City of Federal Wary as to any maim, ([neWdimmy cwtts, expenses, and QtteTneye fees ineurred in the iaeoeestigatton and defense of s—h ctab *, which may be made by a my person, tndudiag the andersigaed, and filed against the city, but only where --mch etabn arises out of the ret&tace of the &ty, inchMing its officers and employers, upon the accuracy of the tnforntation sappiied to the city as a part n. this applicatio ofof �z'vz�P%-� SIGNATU DATE PRWT NAM& - /w-- i 0 Em Bulletin #I 00 -- February 19, 2020 rage I of 2 IL112indolltsTermit Application Nftc iANicAL PERmrr VALUE OFMECHiNICAL WORK $ Indicate how of each type of fExtare to be installed or relocated as part ofthis m ect Do not arc7ade es to remove _ AIR HANDLING UNITS PANS GAS PIPE OUTLETS OTHER (Desaibe) _ AIR CONDITIONER FIREPLACE INSERTS _ HOODS Icne—c A BOILEE FURNACES HOT COMi'RESSORS COMPRESSORS GAS LOG SETS — GERATIANHSST REFRIGERATION SYST I{ DUCTING _ GAS PIPING WOODSTOVES VALUE OF PLUMBING PLUNOLNG PERMIT BATHTUBStormn/�i LAVS(eme l TOILETS WATER PIPING _ DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Desaibe} _ DRAINS SHOWERS VACUW BREAKERS DRINKNO FOUNTAINS SINKS 0� luasrl WATER HEATERS (awl HOSE EIEES ___ SUMPS WASHING MACHINES TOTAL FIXTURES COMMERCIAL-NEWIADD£i ON AREA D=MRWn0N I Area !�j I O uPaao9 C nPfsi Coastrnciion Zof Additional Information ADDMON %-V1Y31Y3 m%-3t—iV'ilY1VLEL! A L`11H1i AREA DESCRTPfION Sam Rmeet Ocenpan T --uvs, Co e10on St z� Additional Iafozmatioa TEFAAT AREA ONLY Bulletin ;#100 — February 19, 2020 Page 2 of 2 k:lHandoutA\Permit Application