08-105663aff or 'A
Federal Way
COMMUJUTY DEVEI. "ENT SKRWCES
33325 8-� AVENUE SOUTH • PO BOX 9718
FEDERAL WAY, WA 98053 -9718
253- 835 -2607• FAX 253- 835 -2609
www. rnuoffederalwau. cam,
-0
PERMIT �� 1DD 1
APPLICATION
tile, follb -ing is required iqfor-athm - an >ff comph6te applica t"
Its —
694F CO ME EL PL DE EN FP
Pleaw PrW hViblr (in inv or tme.
SITE ADDRESS
501 S 318 Place
ASSESSOR'S TAX/PARCEL # 7941700350_
LEGAL DESCRIPTION (e.g. Aare Estates, Lot 1)
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING ❑ MECHANICAL
SUITE /UNIT #
LOT OUR (s, )
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of Mork included on this permit onlul
Replace 8 windows. Like for like; no structural changes
PROJECT NAME (Name of Business or Owner Last Name) RYCKMAN
PROPERTY
OWNER
CONTRACTOR
PROJECT
CONTACT
LENDER
EXISTING USE
PEOPLE INFORbIATION
NAME
PRIMARY PHONE
Dian Ryckman
( 253 ) 941 0399
MAILING ADDRESS
CITY, STATE, ZIP
E -MAIL ADDRESS
501 S 318 Place
Federal Way, WA 98003
23420 68th Ave S, Park 234, Bldg A
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Home Depot At Home Services
Naida Khan
( 253 ) 398 -1560
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
23420 68th Ave S, Park 234, Bldg A
Kent WA 98032
I -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
( )
CONTRACTOR'S RZGIB7'RATION 1QR338t
132 -MTSON DATE
E -MAIL ADDRESS
HOMED'`" 972RQ
02/01 /2009
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Northwest Permit Inc.
Naida Khan
( 3W ) 945 -2787
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
1345 Gulf Road
Point Roberts, WA
I -
RELATIONSHiP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant 14 Agent ❑ Other
( 360 ) 945-2091
NAME PRIMARY PHONE E-MAIL ADDRESS
IVaida Khan/ Northwest Permit ( 360 945 -2787 I naida @nwpermit.com
NAME
Per RCW 19.27.095:
Lender information is required ifpoo}ect value exceeds "000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
( )
Residential
EXISTING ASSESSED /APPRAISED VALUE $ VALUE OF PROPOSED WORK $_
3374.00
SPRn KLERED BUELDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
SQ. FT.
PROPOSED
SQ. FT.
TOTAL
SQ. FT.
BASEMENT
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
FIRST
COMPRESSORS
FURNACES
RANGES
SECOND
GAS LOG SETS
REFRIG_SYSTEMS
THIRD
CHANGE OF USE?
❑ YES
❑ NO
ADDITIONAL FLOORS (DESCRIBE)
UP /SEPA/SU?
o YES
DECK (❑ COVERED OR ❑ UNCOVERED?)
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
GARAGE ❑ CARPORT ❑
ri NO
NUMBER OF FLOORS
aagrua
ra WMM
TOTAL
TOTAL EMEMIB 6Y
70rALrswaeas fir
102" ar
* *NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of f irtum to be installed or relocated as pmt of this project Do not include existing fudums to remain.
Value of Mechanical Work
jA COPY OF BID OR ESTIMATE MUST BE INCLUDED WITHAPPMCATION)
AIR HANDLING UNITS
EVAPORATIVE COOLERS
GAS PIPE OUTLETS WOODSTOVES
BBQS
FANS
GAS WATER HEATERS MISC (Describe)
BOILERS
FIREPLACE INSERTS
HOODS (cam i.4
COMPRESSORS
FURNACES
RANGES
DUCTS
GAS LOG SETS
REFRIG_SYSTEMS
BATHTUBS (or Tub /shw ca "
DISHWASHERS
DRINKING FOUNTAINS
ELBCTRIC WATER HEATERS
HOSE HIBBS
LAVS Bathroom sink.)
URINALS MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
SHOWERS
WATER CLOSETS U iktt
SINKS
WASHING MACHINES
SUMPS
BUILDING SHELL ONLY? ❑ YES ❑ NO
I cert(frj under penalty of perjuury that I am the property owner or authorised agent of the property owner. I certfd It 0 to the rest of mg
knowledge, are inforwadon submitted in support of this permit application is true and correct I certify that I will owwply with all applicable
City of Federal Way regulations pertaining to the work authorised by the issuance of a perms. I understand that the issuance of this permit
does not remove the owner's responsibility for compliance with local state, or federal taws regulating construction or enahonnentai lava.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the
inaestigadioa and defense 4f such ckn_b which nag be made by any person, turhu &W the undersigned, and filed against the city, but only
where such claim arises out of the reliance of the city, including its officers and enjployees, upon the accuracy of the igfornation supplied to
the city as apart of this application.
SIGNATURE:
Owner and /or Authorized Agent
FOR OFFICE USE ONLY Ll
❑ NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR ❑ TENANT IMPROVEffiENT
BUILDING SHELL ONLY? ❑ YES ❑ NO
BASIC PLAN?
❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE?
❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES o NO
UP /SEPA/SU?
o YES
o NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED?
0 YES
ri NO
Bulletin #100 —January 1, 2008 Page 2 of MHandoutsTermit Application