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02-101825.eF CONSTRUMON PERMIT APPLICATION R EC E I V EU PPLI�'ATI01�1' CUMBER' '' VV ,f�Y PPCA7T ©NNIJMBERt ` MAY 0 2 2002 * *7he follovQWWkjiiEfi0i Ip'oAgGn - Please print (In ink) or type"* BUILDING DEPT. Please note: Electrical, Fire Prevention Systems and Engineering permits m$y require a separate application. LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): ■ PRO3ECY INFORMATION TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING0.FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): C-'l wito c A 'DR Esm, ( 204 ) 5T5 - 03 11 MAILING AD RE55 (��FE7 ADDRESS; CITY, STATE, ZIP): �p Vow —6$5 2-6 1 uKw%Lp- \„iA &3a-- CS28 Sw- m—ox A F T %iz- I= s F - S O C,,F- C-- v 1C- e S 1 #3 'Q� la -4 C Ake- '� � RE �N�r.) . �Cr� -1} 8 a- DAYTIME PHONE: $ !r.. r _ MAILING ADDRESS (STREET ADDRESS; CITY, fSTA i , ZIP): EVENING PHONE: RELATIONSHIP TO PROTECT ^ ED ARCHITECT ❑ TENANT ® OTHER ( DESCRIBE): CokJMA -Giv a- FAX NUMBER: PROJECT NAME: �T1-U� ka S ° �IzC - C•O C . PEOPLE INFORMATION PROPERTY OWNER: CONTRACTOR: APPLICANT: NAME: DA.YTiME PHONE: CC-70a -t? (��,G��s 1 (z63) MAILING ADDRESS (MEET ADDRE3S; CM, STATE, !1P): 125 ski CA nt P t&S 'D jigs lF— FC-.b �JP Y VA C1802-3 NAME: DAYTIME PHONE: c RL 0 G- :Etj C- ( 204 ) 5T5 - 03 11 MAILING AD RE55 (��FE7 ADDRESS; CITY, STATE, ZIP): �p Vow —6$5 2-6 1 uKw%Lp- \„iA &3a-- CS28 EVENING PHONE: ( 264 ) 575- - 031) CITY Or FEDERAL WAY BUSINESS LICENSE NUMBER: FATC NUMBER: 0 ` - L O_ 2 g q_ A - © o 1(2--5.3)87Z —7-T93 CON7rACTOR'5 REGISTRATION NUMBER: I EXPIRATION DATE. / 16 / O Z (copy Orcaro MgUfr*d) F 1 g E Q a g g X U.( NAME: --kbd DAYTIME PHONE: F L &S- 00 r- �.y C. MAILING ADDRESS (STREET ADDRESS; CITY, fSTA i , ZIP): EVENING PHONE: RELATIONSHIP TO PROTECT ^ ED ARCHITECT ❑ TENANT ® OTHER ( DESCRIBE): CokJMA -Giv a- FAX NUMBER: EMAIL ADDRESS' CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT C9 CONTRACTOR DETAILED IiUT[ DTNG TNFORMATIC EXISTING USE: KSC- L�aJ`i' & _ EXISTING BUILDING ASSESSED /APPRAISED VALUATION $ PROPOSED USE: G-z- ol efj -r � �� PROPOSED VALUATION FOR IMPROVEMENTS: $ -* L SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/ REQUIRED- ❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) "NEW RESIClENTIAL CONSTRUCTION NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: FLOOR EXISTING S . FT. PROPOSED S . FT. TOTAL BASEMENT MECHANICAL X C6Mt5 pLiN ,b$IGNATIO�! r ^ ^'tl „f , ;, FIRST 230 t EVAPORATIVE COOLER(S) iq,230 SECOND BBQ(S) SOILER(S) FAN(S) FIREPLACE INSERTS) RANGE(S) TNIRD COMPRESSOR(S) DUCTS) FURNACE(S) GAS PIPE OUTLET(5) HEAT SOURCE: FOURTH PLUMBING OTHER FLOORS (DESCRIBE) DECK BATHTUB(S) LAVATORY(S) URINAL(S) GARAGE HOW MANY FLOORS? DISHWASHER(S) RAIN WATER SYS, VACUUM BREAKER(S) TOTAL qQ ` 1, 2 3 0 SHOWER(S) SINKS) i Oil 2 30 f I certify under penalty of perjury that the information furnished by me Is true and Correct to the best of my knowledge, and further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred In the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information s piled to the city as a part of this application, NAME /TITLE: DATE: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR •.,.rr�n "r1'rrrr+ewl'1 t•C;'AI.II:�r.' W' "'�,' " '( " '❑ T:ENAMT:IIMPRO�EMENT ; _� NEt'If a..4 « ❑ ADDITION ❑ A"L ERATION Indicate number of each type of rudure :LOT SIZE:;! N SIGNA`fI01V� ,,.' MECHANICAL X C6Mt5 pLiN ,b$IGNATIO�! r ^ ^'tl „f , ;, Mi BASIC PLAN ?': ❑ YES„ A , ❑: `NO: r` i'i:raw s. �' , AIR HANDLING UNITS) EVAPORATIVE COOLER(S) GAS LOG(S) HOOD(S) REFRIG. SYSTEM(S) WOODSTOVE(S) BBQ(S) SOILER(S) FAN(S) FIREPLACE INSERTS) RANGE(S) misc.( ) COMPRESSOR(S) DUCTS) FURNACE(S) GAS PIPE OUTLET(5) HEAT SOURCE: ❑ ELECTRIC ❑ GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS, VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) GAS PIPE OUTLET(S) SHOWER(S) SINKS) WASH MACHINE OUTLET WATER CLOSET(S) MISC. ( 1 INTERCEPTORS) SUMP(S) 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 s piled to the city as a part of this application, NAME /TITLE: DATE: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR •.,.rr�n "r1'rrrr+ewl'1 t•C;'AI.II:�r.' W' "'�,' " '( " '❑ T:ENAMT:IIMPRO�EMENT ; _� NEt'If a..4 « ❑ ADDITION ❑ A"L ERATION CENSUS CODE.',:I t ,r, :LOT SIZE:;! N SIGNA`fI01V� ,,.' BUILDING 'SHE (:L 6NL1f7,;' ❑.YES'„ ' [] fro "'" X C6Mt5 pLiN ,b$IGNATIO�! r ^ ^'tl „f , ;, Mi BASIC PLAN ?': ❑ YES„ A , ❑: `NO: r` i'i:raw s. �' , y O No t ❑,. FS` SECTSfJN., ...., „,: ,7AWNSFIIP: " „` ..,,,RANGEd, ,.,:....: EW'ADDRESS'REQUIRECS� .,a , pLA7TED..!LOT7 . _'. El_YES„ . ❑ NO ` .. ;,.;:... , .C}iANGE OF USE tl, ...w.::; ❑YES , ❑''NO. , ,,” COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH - PO BOX 9718 • FEDERAL WAY, WA 98063.9718. 253 - 6614000 • FAX' 253 - 661 -4129 www cJiY. f* tLAlY' .Y.�'JLn