22-103599-BLDG PERMIT APPL-8-5-2022CITY OF �=
Federal Way
PERMIT NUMBER
SITE ADDRESS
PROJECT VALUATION
TYPE OF PERMIT
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of Mork to
be included on this permit only
PROPERTY OWNER
CONTRACTOR
APPLICANT
PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
PROJECT FINANCING
When value is $5, 000 or more
(RCW 19.2 7.095)
PERMIT APPLICATION
PERMIT CENTER + 33325 8Ph Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + 1)erinitceiite rr�ityoffederaiway.coin
TARGET DATE
SUITEIUNIT k
ZONING ASSESSOR'S TAX/PARCEL !
XBUILDING ❑ PLUMBING ❑ MECiIANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
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NAME
PRIMARY PHON$
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MAILING ADDRESS
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EMAIL
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PHONE
KAILING ADDR7I,$ T C
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E-MAIL
CITY
STATE
ZIP
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WA STATE CONTRACTOR'S LICENSE R
VaPIRAATION DATE
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NAME
P9MIARY PHONE
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NAME
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OWNER -FINANCED
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under 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 iRformation 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 suppHelto the city as ayart of this application.
PRINT NAME:
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Bulletin 4100 — February 19, 2020 Page l of 2 k:lllandoutSTernlit Application
MECHANICAL PERMIT
VALUEOFMECH X LWORK
$ �
Indicate how of each Nove o
re to be mstaNed or relocated --P,rt,f
this ct Do not include toto remain.
_ Al. HANDWNG UNITS
FANS
CAS PIPE OUTLETS
OTHER (Deecrlbe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS,.we,
_ BOILERS
FURNACES
HOTWATERTANKS,—,
COMPRESSORS
DUCTING
GAS 1,00 SETS
GAS]NINNO
REFRIGERATION SYST
1
WOODSTOVES
PLUMBING PERMIT
VALUE OPPLUna3mG WORK
000
trrdirnte
how o each e o re b be irLstalled or relocated as rt o this Do not include res to remain.
BATHTDBS,NO/sne...c®m� LAV9 ix..eswy TOILETS WATER PIPING
_ DISHWASHERS RAINWATER SYSTEMS URTNALS OTHER(Describe)
_ DRAINS SHOWERS VACUUM BREAKERS
DRINKINGFOUNTAINS _ SINKS aawm/ae WATER HEATERS u`7)
HOSE BIBBS _ SUMPS WASHING MACHMES TOTAL FL4TORea
GENERAL INFORMATION
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WMIIVG 69PPY®.036YBSRGi
❑ Yes No
PHOPo86n YM69VPPn6BBg9 T9'1'6MT
❑ Yes, NO
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in sq. feet)
EABTING
PROPOSED
TOTAL
FOR OFFICE use
BASEK[ENT
FIRST FLOOR (or Mobile Nome)
SECOND FLOOR
COVERED ENTRY
f^
l'I
U't�
-....._...._._—......_
DECK
f N�^o
GARAGE % CARPORT ❑
OTHER (describe) (..
Area Totals
-NEWNOlIEB mn.
ESTIMATED SELLING PRICE $1 # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
.nLTaer� Fttt
Occupancy GToup(NI
Cove[ruMbv
Y of "I.matbnal
Ivfotmetbn
New Bummulo
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
ARSA DESCRIPTION
An & I. et
Occupancy Gaougal
CovaGuctlon
# of
Stories
Addttbnal I�'oTmetbv
TOTAL E18IDA6
TanANT AREA ONLY
PROJBCTAREAO64
Bulletin k100- February 19, 2020 Page 2 of2 k:HandouWPermit Application