02-104109Flo,1111W. Ft.):
Census Category .................. ...............................
Permit for Building Shell On No
Will Cerd ate of Occup A Ms.
I hereby certify that the above
the occupancy and the us
the Citv of Federal Wa
roofing p
.. .......................
..... ...............................
V, 4? W
C 22, 2003, IF N S STARTED.
issued on Septe er
is ect and that constructio a above escrib
lance with the la les and regula ions of the at as
l
D OZ
1
and
n and
City of Federal Way
Building - Commercial P
- 104109 - 00 - CQ0
Community Development Services
33530 1st Way S
Federal Way, WA 98003 -6210
Ph: 253.661.4000 Fax: 253.661.4129
In
ction re est line: 253.835.3050
Project Name: DUMAS BAY CENTER
Project Address: 3200 SW DASH POINT RD
arcel Number: 122103 9146
Project Description: COM REP - Install roof mainIgn a sys - insta w a
It emulsion over existing BUR roof.
Owner
scant Contractor
, Lender
CITY OF FEDERAL WAY -PARKS CO
R IN R COMMERC INDST
NONE
33530 1ST WAY S 1
HWY COMMEI *20 51
FEDERAL WAY 9800 L
WOOD 9 15331 HWY 99
LYNNW 803
NO
jWA
I de
us cateaor on -st
#1 1#2
#4 r
Flo,1111W. Ft.):
Census Category .................. ...............................
Permit for Building Shell On No
Will Cerd ate of Occup A Ms.
I hereby certify that the above
the occupancy and the us
the Citv of Federal Wa
roofing p
.. .......................
..... ...............................
V, 4? W
C 22, 2003, IF N S STARTED.
issued on Septe er
is ect and that constructio a above escrib
lance with the la les and regula ions of the at as
l
D OZ
1
and
n and
Cff• CONSTRAPION PERMIT APPLICATION
ELEIZF =iL S I P 2 3 2002 PPLICATION NUMBER:
uV rav 4 - -t
CITY OF FEDERAL WAY APPLICATION NUMBER:
BUILDING DEPT. PPLICATION NUMBER: - -
* *The following is required information — Please print (in ink) or type ** `,�
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
PROPERTY • •
SITE ADDRESS: _ 332,50 32,50 560 DkjaH ^!nl i f� ASSESSOR'S TAX/ PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):
PR03ECT INFORMATION-
TYPE OF PROJECT (This application): BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION provide detailed description): LA
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
APPLICANT:
N
"4/,Cj
NAME: _ DAYTIME PHONE:
C4 OE 94e e c Gu ( ) -
MAILING APDRESS (STREET ADDRESS; CITY, STATE, ZIP):
NA Ea —'J U 4-
�o
^
DAYTIME PHONE:
( )Y s
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP):
l s 3 Av ?
S03
EVENING PHONE:
(4 ) 7s -
ETA
y Aw ci
w4-
7
CITY OF FEDERAL WAY BUSIN LICENSE NLIMEkEk e /
—— -
- - - --
-
--
FAX NUMBER:
415)74?- -4Z.fZ
CONTRACTORS REGISTRATION NUMBER:
(a)py of card required) L m flK
E- 1 o
EXPIRATION DATE:
S/
/03
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT ❑ OTHER ( DESCRIBE):C¢Q 7-,v-±Sp2f ( ) -
,� E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT Ct�J ONTRACTOR
■ DETAILED BUILDING INFORMATION
PROPOSED USE:
EXISTING BUILDING ASSESSED /APPRAISED VALUATION $
p cJtJ
PROPOSED VALUATION FOR IMPROVEMENTS: $ �D' ` l'
SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER:
SEWER SERVICE PROVIDER:
❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
* *NEW RESIDENTIAL CON
STRUCTIO LY **
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING S . FT.
PROPOSED S . FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
....�.�_... ti..s.u. ._T ::.., �.>.. ��: �. .�'.�..�..S.��...�:•f�.- �a.�tf' FIXTURES. ��frN.., �F�. r., �. �.,. �:. �,: ��. r;. ��- �. � ,:.�.�.,- ,.�...�.�ti��,.�. «t;.n1
AIR HANDLING UNIT(S)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHERS)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTORS)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOGS) REFRIG. SYSTEM(S)
FAN(S) HOOD(S) WOODSTOVE(S)
FIREPLACE INSERTS) RANGE(S) MISC. ( _)
FURNACE(S)
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAIN WATER SYS. VACUUM BREAKER(S) El ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S) MISC. ( )
SUMP(S)
■ - DISCLAIMER /SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy
of the information supplied to the city as a part of this application. j
NAME /TITLE: 1 /� /! - /�/id �' _069 DATE: V2-3/4?
❑ PROPERTY OW R ❑APPLICANT /L!I CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES • 33S30 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL. WAY, WA 98063-9718 • 253-661 -4000 • FAX: 253-661 -4129
W W W.dty0ffede-n1Way.CDM