08-100305NOR,— J
an,•� � ' ' JAN 18 2008 0 4 .0
CDLMUNli'DEVAD.Pi181 S RVJ= P•E i� 1C$�f iF O F FED E RA* IsM&c M EL PL DE EN IPP
s999FEDMALWAY, WAT 8 POBOX 9718
A P P LI CATI O N�
FSDBRAL WAY, WA 98069.9716 D
959- Q9S7607-FAXT59�35•T6d9
tinriw. aYSaA'ederohuay. rom
The following is required Worntation —an incomplete application will not be accepted. Please print.legibly (in ink) or type.
Z6 r PROPERTY • •
SITE ADDRESS? t of L 6 T V ,► L �� w' SUITE /UNrf —I J--:;,
ASSESSOR'S TAR /PARCEL # LOT SIZE (sj)
LEGAL DDE/SC( ON (e.g. Acme Estates, Lot 1)
TYPE OF PERMIT ❑ BUMDING ❑ PLUMBING. . 1ECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this hermit only)
PROJECT- NAME (Name of Business or Owner Lit Namel
PROPERTY
NAME
PRIMARY PHONE
OWNER
CITY, STATE, ZIP
CELL PHONE
PHONE
MAIWNG ADDREW
GTY, STATE, ZIP
E-MAIL ADDRESS
CITY, STATE,
PHONE
s
_
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
COMPANY NAME
APPLCANT NAME
APPLICANT NAME
OFFICE PHONE
CITY, STATE, ZIP
CELL PHONE
PHONE
MAILJN0 ADDRESS
RELATIONSHIP TO PROD Em
CITY, STATE,
PHONE
s
_
a
G F ER-AL
WA.jY B SINESS LCNSE ER N DATE
FAX NUMBER
CONTRACTOR'S REGISTRATION NUMBER
C C Z" TION DATE 6
&MAIL ADDRESS
COMPANY NAME
APPLCANT NAME
OFFICE PHONE
MAILING ADDRESS
'p
CITY, STATE, ZIP
CELL PHONE
PHONE
-
RELATIONSHIP TO PROD Em
FAX NUMBER
❑ Architect ❑ Tenant ❑ Agent ❑ Other
NAME PRIMARY PHONE &MAIL ADDRESS
NAME
Por RCW 19.27.095: .
Lender information is required i/project value aveseds $5,000 .
MAWNO ADDRESS
CITY, STATE, ZIP
PHONE
EXISTING USE PROPOSED USE
EXISTING ASSESSED /APPRAISED.VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING? D YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
THIS CARD IS TV#EMAIN ON -SITE `
CITY OF *CommunityDevelopment Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835 -3050
PERMIT #: 08- 100305 -00 -ME
Owner: FOREST COVE -388 LLC
Address: 31009 16TH PL SW
FEDERAL WAY, WA 98023 -4389
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on -site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence On -going inspections
are logged on the back of this card.
Mechanical Rough -in (4165) Gas Piping (4125) Final - Mechanical (4065)
Approved Approved to release test Approved
By Date ,.a By Date By C Date 1. _ p$
For in_pector reference only
❑ Rough Electrical ❑ FINAL - Electrical
Approved Approved
By Date By Date
-I-
crtre. JAN 18 2008 _ 3
Frfty. . PEP T� L� �$-- -�- - ' Z
C0MWffDXV9W,P�if8Nr8BRVICSB 1L�I�f�F OF FEDERAIsAVc M EL PL DE EN PP
999 ?S ATM AV$ WAY,WA7f /•PO9718 d APPLICATIOlV�
53-814-2 WAY, WA 98069.9718 DJ`
?39. 835 - ?60T PAX ?59•d95 -?609
tt�wu.rlhroQ'edervhuey.rom
The following to required {,{formation -an incomplete application wilt not be accepted. Please print,tegibiy (in inkj or type.
8ITE ADDRESS I Tq p �� SUITE /UNIT # _? t -C
A38ESSOR S TAX /PARCEL P LOT BIZE (Sp
LEG /AL DErSC ON (e.g. Acme Estates, Lot I)
(1 � ! Fta P�e+lm► QwY>�► +iP V
TYPE OF PERMIT o BUILDING o PLUMBING jt6MCHANICAL
Cl DEMOLITION o ELECTRICAL Cl ENGINEERING O FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on Ods l2ermit only)
PROJECT. NAME (Name of business or Owner Last Hamel
PROPERTY'
OWNER
CONTRACTOR
APPLICANT
PROJECT
CONTACT
LENDER
EXISTING USE
NAMB
PRIMARY PHONE
5- e4
/ -
\E-
MAIUNO ADDRESS
CITY, STATE, ZIP
MAILADDRES9
I
/
RELATIONSHIP TO PROJ
COMPANY NAME
APPLICANT NAME
APPLICANT NAME
OFFICE PHONE
CITY, STATE, ZIP
CELL PHONE
QX UNG ADDRESS
g
RELATIONSHIP TO PROJ
CITY, STATE, zlP �� ,,
PHO E
( -
FEDERAL WAY BUSINESS LICENSE NUMBER, ON DATE
FAX NUMBER
CONTRACTOW5 IMMTRATION NU
lipalflow DATZ
C
E-MAIL ADDRESS
\
COMPANY NAME
APPLICANT NAME
OFFICE PHONS
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
RELATIONSHIP TO PROJ
FAX NUMBER
O Architect o Tenant o Agent o Other
( -
NAME PRIMARY PHONE E MAB.ADDRBSS
NAME
PerRCW 19.27.096,
Lender information is required t jprq/ect value exceeds $5,000 .
M R0 ADDRESS
.
C1TY, STATE, ZIP
PITONS
( -.
PROPOSED USE
EXISTING ASSESSED /APPRAISED. VALUE $ VALUE OF PROPOSED WORK $
SPRINKLERED BUILDING?
WATER SERVICE PROVIDER
SEWER SERVICE PROVIDER
E3 YES D NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? ❑ YES O NO
• LAKEHAVEN o HIGHLINE o TACOMA a PRIVATE (WELL)
• LAKEHAVEN O HIGHLINE O PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
8 . FT.
PROPOSED
$ . FT.
TOTAL
S . FT.
BASEMENT
a YES o NO
BASIC PLAN?
FIRST
ti NO
ZONING DESIGNATION
SECOND
CHANGE OF USE?
a YES
o NO
THIRD
a YES a NO
UP /SEPA /SU?
ADDITIONAL FLOORS (DESCRIBE)
a NO
=PLATTED LOT?
a YES o NO
DECK (O COVERED OR O UNCOVERED
DEMO PERMIT REQUIRED?
o YES
a NO
GARAGE ❑ CARPORT O
NUMBER OF FLOORS
sasruo
Psorosso
Tore.
Toru.aarrspsr
Torscrsawussr
for"ar
"!NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate. number of each type of fixture to be installed or relocated as part of this project. Do not include existing fudures to remain.
Value of Mechanical Work
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
BATHTUBS I.rub /ehm W Cm "
DISHWASHERS
DRINKING FOUNTAINS
i' � M COPY DFBID OR ESTIMATE MUST BE INCLUDED WrMAPPLICATIOIW
EVAPORATIVE COOLERS OAS PIPE OUTLETS WOODSTOVES
FANS GAS WATER HEATERS MISC (Describe)
FIREPLACE INSERTS HOODS p nn d q
FURNACES RANGES '
GAS LOG SETS REFRIG. SYSTEMS
LAVS (s ft. sh*4
RAINWATER SYST
SHOWERS
ELECTRIC WATER HEATERS SINKS
HOSE BIBBS SUMPS
URINALS MISC (Describe)
VACUUM BREAKERS
WATER CLOSETS trw"
WASHING MACHINES .
Z esrt(N under penalty ef perjury that t an the property owner or authorised 'agent of the property owner. t eerft that to the best of my
knowledge, the it f oration submitted in support of this permit application is true and correct. I eerti/k that t will eomp(y with all applicable
City of llydtratl Way regulattlons pertaining to the work authorised by the issuance qf a permtL t understand that the issuance of this permit
does not remove the owners responsibility for compliance with loca4 slate, or federal laws regulating construction or environmental laws.
t jlurther agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' jets incurred in the
investigation and defense of such claim), which may be made by any person, including the undersigned, and Plod against the city, but only
whore such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the 1q formation supplied to
the city as a part of this application.
SIGNATURE:ct `�— DATE
Property Owner and /or Authorised Agent
a NEW a ADDITION
a ALTERATION
a REPAIR o TENANT IMPROVEMENT
BUILDING OREM ONLY?
a YES o NO
BASIC PLAN?
o. TES
ti NO
ZONING DESIGNATION
CHANGE OF USE?
a YES
o NO
NEW ADDRESS REQUIRED?
a YES a NO
UP /SEPA /SU?
a YES
a NO
=PLATTED LOT?
a YES o NO
DEMO PERMIT REQUIRED?
o YES
a NO
Bulletin #100 —January 1, 2008 Page 2 of 4 MandoutAPern it Application