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06-104890CITY OF SEP 2 6 2006 Federal war XYERMI T COMMUff YDBVELOPMENT SERV/CB. ITY OF FEDERAL 93325 dTe AVERUS, WA. 9. 63 BOX 97 B U I LD I N C�/Q TT L I C AT I O N FEDERAL WAY, WA 98063-9718, 2S3-835.2607• FAR 253435-2609 unuw. dtuofredemfivau, aom is 0 CO ME EL PL DE EN FP will not be accented. Please SITE ADDRESS �V % ASSESSOR'S TAX/PARCEL #) LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) IAa. nch SW—PW/-ICY Ind I TYPE OF PERMIT PROJECT DESCRIPTION (Provide detailed description of work or SUITE/UNIT • LOT SIZE (s,) ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM PROJECT NAME (Name of Business or Owner Last Name) PEOPLE•• • PROPERTY OWNER CONTRACTOR APPLICANT CONTACT LENDER NAMEPRIMARY PHONE Q/ � � �r vi —I (zoG ) 37Z MAILING ADDRESSCITY STATE, ZIP zvz -OU H7 -36c) S �&x1( U 96:1063 COMPANY NAME APPLICANT NAME OFFICE PHONE OFFICE PHONE ' MAILING ADDRESS CITY, STATE, ZIP CELL PHONE CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER CELL PHONE ' CONTRACTORS REGISTRATION NUMBER (copy of card required with a}eh application) EXPIRATION DATE RELATIONSHIP TO PROJECT COMPANY NAME APPLICANT NAME OFFICE PHONE ' MAILING ADDRESS CITY, STATE, ZIP CELL PHONE ' RELATIONSHIP TO PROJECT FAX NUMBER ❑ Architect ❑: Tenant ❑ Agent ❑ Other (Describe) EXISTING USEPROPOSED USE -S 9✓'i L EXISTING ASSESSED/APPRAISED VALUE $ _ S�UQQC0 VALUE OF PROPOSED WORK $ SPRINKLERED BUILDING? d YES 2r/KO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SF WER 4ERVIC`E PRnVinFR n. T.sTZFt7etTT N n [7T/STST.TKTL• n DDT[Ta Tc /QL+T"T^V 111)I 0 'fudure to be installed or relocated as part of this project. Do not include existing fixt"res to. MECUMCAL Value of Mechanical Work $�1 c�. (-' es r O o-, 0vj� e AIR HANDLING UNITS EVAPORATIVE COOLERS OAS LOGS REFRIG. SYSTEMS BBQS FANS HOODS (co rctA WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC (Deacn'be) COMPRESSORS FURNACES GAS WATER HEATERS i� .DUCTS GAS PIPE OUTLETS BATHTUBS iorTuh/stweercomtwi SHOWERS WATER CLOSETS iro&q MISC (Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS IAVS lg,tb,o„Na4 VACUUM BREAKERS ELECTRIC WATER HEATERS I cert(fy 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 authorised 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 ei neluding costs, expenses, and attorneys' fees incurred in the investigation and defense of such clainQ, which may be made by any perso , in siding the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the ci g i s and employees, upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE,- t�v`'s•'� o— DATE 4` ZE Gi� (Signatu-) (Title) RELATIONSHIP TO PROJECT Owner 0 Agent 0 Contractor 0 Architect O Other P3� RIPTION EXISTING PROPOSED TOTAL RBASEMENT S . FT.S . FT. 3 . FT. FIRST ZOO, SECOND THIRD FOURTH Iry ADDITIONAL FLOORS (DESCRIBE) ) �.�V, Y` /ZO / Z o DECK (COVERED?) v GARAGE D CARPORT O. NUMBER OF FLOORS XIMMO raoroeso Z Toru. "NEW HOMES ONLIY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ 1 'fudure to be installed or relocated as part of this project. Do not include existing fixt"res to. MECUMCAL Value of Mechanical Work $�1 c�. (-' es r O o-, 0vj� e AIR HANDLING UNITS EVAPORATIVE COOLERS OAS LOGS REFRIG. SYSTEMS BBQS FANS HOODS (co rctA WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC (Deacn'be) COMPRESSORS FURNACES GAS WATER HEATERS i� .DUCTS GAS PIPE OUTLETS BATHTUBS iorTuh/stweercomtwi SHOWERS WATER CLOSETS iro&q MISC (Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS IAVS lg,tb,o„Na4 VACUUM BREAKERS ELECTRIC WATER HEATERS I cert(fy 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 authorised 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 ei neluding costs, expenses, and attorneys' fees incurred in the investigation and defense of such clainQ, which may be made by any perso , in siding the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the ci g i s and employees, upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE,- t�v`'s•'� o— DATE 4` ZE Gi� (Signatu-) (Title) RELATIONSHIP TO PROJECT Owner 0 Agent 0 Contractor 0 Architect O Other P3� G,194 -.4 oN C. ©�;, /,4C Cfoyc- .4n--,4 !%lvc �c��w 0,060 l�rlVe �gil/ fro o v -csi �,OG6 ros}p� ��N; o^'��` — Za ��pit, � Z� DS O Ll✓ . �� -4vk4oTlZ � t"f�V3� LPi I "LIZ ol 000 � o. ��0 nj OVC� N S `Df ,AIJ EF 120 RECEIVE© I.p o SEP 2. 6 2006VTY OF FEDERAL wAy . i qo.o BUILDING DEPT. 7� D 7 7�V—Le�yP✓ — WA%�%OW �i aN 1 - Z?QaAfcr n /wrT`j �cLS �lX G/'4i��,� zsS�tc�S IC -CH o ;