07-105605crrrar
Ftdera[Way RECOVEG PERMIT
COMMIZIMDEVELOPMENTSERVICEs SF MF CO ME EL PL DE E I+P
33725 D R,1U Wfs, WITH PO BOX 97UC. 1 I �APPLICATION
F3DERAL WAY, AX 98063A718 [ f b
753-a35.2607- f�iC 759435.7589
"u l U. ri t H D(l-e [ ] erR11 W 1 q, Cq}a
C17-Y DF F ❑
The following is requ"a ;AR & incomplete application will not be accepted. Please print.legibly (in ink) or type.
PROPrRTY INrolzmmiox
SITE ADDRESS 334 5 -5 46T " A J& S , SUITE/UMT #
ASSESSOR'S TAX/PARCEL t C)- d 3 q C LOT SIZE (,j)
LEGAL DESCRIPTIONi (e.g. Acme Estates, Lot 1)
(Attach separate page jar lengthy legal d-cripttm)
PROJECT• •
'TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlui { ,
_u I iDge_u-CoNo Ft iLe- Sriyo cA j_ A 5 iy f±t 6FF 14-E
PROJECT NAME (Name of Business or Owner Last Namel GEDFiQ �A2tC ee �a�ST u
PEOPLE• •
&PROPERTY
�DWNrR WAr-t Yk�i�O�- u-L
PHONE
CONTRACTOR
,,, APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAME
PRIMARY�
I
COMPANY NAME
E u�o•�j Ca.1 vtTto•�)
APP CANT NA,htE
`f
OFFICE PHONE
(MU -7 6- 3b10
MAILING ADDRESS
79 33 — 5 r` E_ S _
CITY, STATE, ZIP
SE4-rm L L-jr 'q S I a%
CELL PHONE
M- Z55. - 303Z
CITY OF FEDERAL WAY BUSINESS LICENSE NUMFIER EXPIRATION DATE
FAX NUMBER
(2.CJO)761 -_�_Wz
roc) z r3c�6?
CONTRACTOR'S REGISTRATION NUMBER EXPMA71ON DATE
F-MAIL ADDRESS
CO PAHY NAME
APPLICANT N MB
JA`1 �LAA tL
OFFICE PHONE
{' )7%1 ��Sla
MAILING ADDRESS
lt-\153 - S't*-'- Fiv e_. S -
CITY, STATE, ZIP
bf-Ar tt.E wIp,
CELL PHONE
z
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent IKdther
FAX NUMBER
(Zab M_• - 13q
NAME PRIMARY PHONE E-MAIL ADD RES S
Gd�
NAME
Per RCW 19.27.09Sr
Vender info d-Po is required if oject value exceeds $S1000
H1e�i G DR£SS �� ��
C , 57ATF.rL1P
PHONE
EXISTING ASSESSED/APPRAISED VALUE $
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE
GRATER SERVICE PROVIDER ❑ LAKEHAVEN ❑Wf-'iiLINE
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE
UE OF PROPOSED WORK ;$ LI. SDO
REQUIRED? ❑ YES ❑ NO
❑'TACOMA ❑ PRIVATE (WELL)
❑. PRIVATE ISEPTIC)
Indicate number of each type ojfixture to be instaIletl.vr relocated as part of t3ais prof Do not include existin
g futures to remain.
MECHANICAL
Value of Mechanical Work $ (A COPY OF BID OR IMATE T BE INCLUDED WITHAPPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLER GAS PIPE OUTLETS
BBQS WOODSTOVES
FANS GAS WATER HEATERS MISC (Describe)
BOILERS FIREPLACE INSERTS
GODS (Commerelan
COMPRESSORS FURNACES RA GES
DUCTS GAS LOG SETS REF G. SYSTEMS
BATHTUBS (or7tib/shower combo) LAVS (Bethr .Sk cv) URINALS
DISHWASHERS RAINWATER SYST MISC (Describe)
DRINKING BERS
NG FOUNTAINS SHOWERS WATER CLO ETS
ELECTRIC WATER HEATERS SINS ITouey
HOSE BIBBS SUMPS WASHING M¢CHJNES
I certify render penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best of my
knowledge, the In/brmation submitted in support of this permit appltcatlon is true and correct. I cert(fy that I rerc comply with all applicable
City of Federal IVay regzrtations pertaining to the work authorized b the issuance of a permit. I understand that the issuance of this permit
does not remove the owner's responsib[I#ty for ompl[ance u4tli locva Late, pr fedrraI lava regulating construction or environmental taws,
I further agree to hold harmless the ty of F rar// �'ay 03 any claim (including costs, expenses, and attorneys' fees incurred in the
investigation and defense of such cIa[m which ay be'rnadrb any person, including the undersigned, and filed against the city, but only
where such claim arises out is the . ne of e etty�in� t its officers and employees, upon the accuracy of the information supplied to
the [Sty as a part Of this application.
ISrGNATURE:
o NEW a ADDITION
BUILDING SHELL ONLY?
ZONING DESIGNATION
NEW ADDRESS REQUIRED?
PLATTED LOT?
a. ALTERATION
o YES o NO
o YES a NO
o YES o NO
Authorized Agent
a REPAIR ❑ TENANT IMPROVEMENT
BASIC PLAN?
CHANGE OF USE?
-UP/SEPA/SU?
DEMO PERMIT REQUIRED?
❑ YES o NO
o YES o NO
o YES o NO
o YES o NO
Bulletin #100=August 16, 2007 Page 2 of
MHandcutsYermit Application