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06-100702 (2)PlECElVEE ····, .. !_L I/I -Lt2__ D ~o <t_ SF MF CO ME EL PL DE EN FP I I SITE ADDRESS 2107 South 320th -----------SUITE/UNIT it ----- ASSESSOR'S TAX/PARCEL # 7 6 2 2 4 0 - 0 0 1 0 LOT SIZE (sf} 4,600 LEGAL DESCRIPTION (e.g. Acme Estates, Lot l) ___ Attached. _____________________ _ (Attach :sepOTole pQ(Je for len(flhy legt;1l de:Jm"pnonj • PROJECT INFORMATION TYPE OF PERMIT )1 BUlLDING D PLUMBING D MECHANICAL 0 DEMOLITION D ELECTRICAL D ENGINEERING D FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this pennit only) Panera's Grading Permit SQ O O\ PROPERTY OWNER CONTRACTOR APPLICANT NAME Steadfast Commons MAJUNO ADDRESS 4343 Von Karman Ave Suite 300 I CITY. STATE, ZIP Newport Beach, CA 92660 COMPANY NAME APPLICANT NAME SD Deacon Jim Erickson MAILING ADDRESS CITY, STATE, ZIP 2375 130th Ave NE Suite 200 Bellevue, WA 98005 CITY OF FEDERAL WAY, BUSINESS LICENSE NUMBER EXPIRATION DATE ---I I --B L CONTRACTOR'S REOIS1'RA'l'ION NUMBER (copy of cud required with ..acb appUeationl COMPANY NAME APPLICANT NAME Steadfast Companies Lance Emery MAILING ADDRESS CITY, STATE, ZIP 4343 Von Karman Ave Suite 300 Newport Beach, CA 92660 RELATIOl'ISHIP TO PROJECT o Architect o Tenant D Agent D Other (Describe) I PRIMARY PHONE ( 949 I 852-0700 OFFICE PHONE ( 206) 850 -1760 CELLPHONE ( } - FAX NUMBER ( ) - EXPIRATION DATE I I OFFICE PHONE ( 949 ) 852-0700 CELLPHONE ( 714) 337-0067 FAX NUMBER ( 949 ) 777-8278 CONTACT I NAME I PRIMARY PHONE I E-MAI~ ADDRESS Lance Emerv 949 852 0700 lemerv@steadfastcompanies.com LENDER PerRCW 19./27;095: under tiiformo.tton ls NAME nqufred if project value exceed.ti $5,000 MAIUNO ADDRESS CITY, STATE. ZlP · • DETAILED BUILDING INFORMATION EXISTING USE ~P.;!!ar~k~l:!a!nilig..!L~o~t ____________ PROPOSED USE Restaurant EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $. ______ _ SPRINKLERED BUD,DlNG? DYES ONO WATER SERVICE PROVIDER o LAKEHAVEN SEWER SERVICE PROVIDER o LAK.EHAVEN FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? o YES o HIGHLINE D WGHLINE o TACOMA o PRIVATE (WELL) D PRIVATE ISEPTIC) ' PROJECT FLOOR AREAS o NO \ ) - ~ AREA DESCRIP'nON EXISTING PROPOSED TOTAL SQ.FT. SO. FT. SO. FT . . BASEMEN'Tr . FIRST 4,600 SECOND THIRD FOURTH ADDITIONAL FLOORS (DESCRIBE) DECK (COVERED?) GARAGED CARPORTO NUMBER OF FLOORS I ltXIB'l'IRO I PROPOSZO I T<Yl'AL 'J'OTAI. SlaSfll<~ ~ 'l'OTAL IPllCPOSSO ff TOTAl,5F •*NEW HOMES ONLY0 NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fvcture to be installed or relocated as part of this project. Do not include existing fvctures to remain. MECHAMCAL Value of Mechanical Work $ AJR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIO. SYSTEMS BBQS FANS HOODS !Commorciall WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC {Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS (or Tub/Shower Cua,l») SHOWERS WATER CLOSETS l'f•il•Q MISC (Describe) DISHWASHERS SINKS DRINKlNG FOUNTAINS OAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LA VS ffinlhroom Sink•' VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/ SIGNATURE BLOCK I certify under penalty of perjury that the iriformation furnished by me Is true and correct to the best of my knowledge, and further, that I am authorized by the owner of ths above· premises to perform the work for 1vhfch the p,irmit application ts made. 1 further agree to hold harmless the City of Federal Way as to any claim (Including costs, expenses, and attorneys' fees incurred tn the tnvestlgatfon and defense of such claim}, which may be made by any person, including the undersigned, and filed against the Ctty of Federal Way, but only where such claim arises out of t .h13 reliance of the ctty, inclu g tts officers and employees, upon the accuracy of the information supplied to the city as a part of tMs application. NAME/TITLE ___ c;__ __ ....::::,-J..--"-..?---1-----------------DATE ------------(Tille) RELATIONSIDP TO o Contractor o Architect o Other ______________ _ FOR OFFICE U$E ONLY l oNEW o ADDITION D ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? oYES oNO BASIC PJ;.AN? oYES a NO ZONING DESIGNATION CHANGE OF USE? oYES oNO NEW ADDRESS REQUIRED? oYES oNO UP/SEPA/SU? oYES oNO PLATTED LOT? oYES oNO .DEMO PERMIT REQUIRED? oYES oNO Bulletin# I 00-August 19, 2004 Page 2 of 4 k\Handouts\Permit Application