Loading...
02-105088RECEIVED CONSTRUCTION PERMIT APPLICATION PPUCAnON NUMBER: ® Z NOV 1 4 LOOT PPUCATION NUMBER: PPUCATION NUMBER: - *"(jiTeYgg BRA ~aformation - Please print (in ink) or type ** Please note: Electrical, infra �reveen% �-5yifsms and Engineering permits may require a separate application. SITE ADDRESS: ASSESSOR'S TAX /PARCEL *: — — — — — — — ` — LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY): PROJECI- INFORMATION TYPE OF PROTECT (This applkation): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING )(FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description): ADD (q) Ste^ t - pECCSSEO Pe"oAmjT SOe lei <t -E 2 S A�� Z,F �LiC r�;.t ((� ) 56M I - 12CCGSS6D .�DAVTS W irN C-k iST�N Q c rC�E S. AAiu PLOO N OJ 05sc> ou LET t tO KEMObEI.eo 11iN&IAwr AREAS. PROJECT NAME: I^/d t�L� U tS I C) 0 PROPERTY OWNER: CONTRACTOR: APPLICANT: �l�l P[FkG�i,JwE�C (206 q/ - 1456 MAHIRG ADDRESS (STREET ADDRESS; CITY, STATE, ZIP): EVENING PHONE: CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: 01 - I r? S - O — FAX NUMBER: Q,66 ) Z 1 REGISTRATION NUMBER: EXPIRATION DATE: (mPY of Card ►a4o-W) L /07/09 O k1 UOAT�5 (1a6 ) 2q i - 1456 MAILING ADDRESS (STREET ADDRESS; CITY, STATE, ZIP). EVENING PHONE: SZv 10" Ave S0Lr"q vi *E too ( ) RELATIONSHIP TO PROJECT: IIt - FAX NUMBER: ❑ ARCHITECT ❑ TENANT XOTHER ( DESCRIBE): DL510 NEK UP6 ) ZQ ( - 1 CjQO CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER X APPLICANT a CONTRACTOR I WA1-S e -fXC0 /NT, C jAjj EXISTING USE: EXISTING BUILDING ASSESSED /APPRAISED VALUATION ; PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: � SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED: ❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER: ❑ LAK9HAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) • "NEW RESIDENTIAL CONSTRUCTION ONLY" NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: S PROJECT FLOOR ARFAS FLOOR EXISTING S . FT. PROPOSED SQ. FT. TOTAL BASEMENT COMP PLAN DESIGNATION BASIC PLAN? ❑ YES . ❑ NO SECTION I TOWNSHIP RANGE FIRST PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO SECOND THIRD FOURTH OTHER FLOORS (DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: am 10.01LUN� Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG. SYSTEMS) Bows) FAN(S) HOOD(S) WOODSTOVE(S) BOILERS) FIREPLACE INSERT($) RANGE(S) MISC. ( ] COMPRESSOR(S) FURNACE($) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ OAS PLUMBING BATHTUB(S) LAVATORY(S) T_ URINAL(S) WATER HEATERS) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS s DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) _ MISC. ( ] INTERCEPTOR(S) SUMPS) 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 Bar authorlead 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 daim (Including costs, expenses, and attorhaW few 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 smpkryees, upon the accuracy of the brformation supplied to the Nty as a part of this applicatbp. NAME/TITLE. l DATE: 1, ©� Z�50z_ ❑ PROPERTY OWNER XAPPLICANT ❑ CONTRACTOR FOR OFFICE USE ONLY: ❑ NEW ❑ ADDITION ❑ ALTERATION o REPAIR ❑ TENANT IMPROVEMENT CENSUS CODE: LOT SEM: ZONING DESIGNATION: BUILDING SHELL ONLY? ` ❑ YES o NO COMP PLAN DESIGNATION BASIC PLAN? ❑ YES . ❑ NO SECTION I TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO COMMUNITY DEVELOPMENT SERVICES • 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063 -9718. 253- 661 -4000 • FAX: 253 - 661 -4129