16-105455F
•CEIVED •
, O 2 E PERMIT APPLICATION
Federal Way NOV 15 2016 PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609+permitcenterwcityoffederalway.com
CITY OF FEDERAL WAY
CDS
PERMIT NUMBER ' _ 1 O 5 ct s / _ F ? TARGET DATE N I Pr-
SITE ADDRESS �^ SUITE/UNIT N
1 _ _ ' 5-J 0.._( v0.._( v.9,..(v.9 1 1, c—k-t 3 c 4 4--- (...1(N/ 7 (...14
I PROJECT VALUATION ZONING ASSESSOR'S AX/PARCELS
1 $ Sct'W Lt 1 t et Z 0 - E7S -7 / Cc
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING*FIRE PREVENTION
NAME OF PROJECT l J
`i 1C� .K.N.0"t._ 'RoP Cc,te00 \ke.GO 5YSie•1,0\ P.',1-e.
PROJECT DESCRIPTION
Detailed description of work to C.` X 151-No C- 12._N I Uti\C S 10'7 2■\'. c- 1(Lc- /A i_-N 2 VA ()(\ J C L-
be included on this permit only
NAME PRIMARY PHONE
112%0-:-%(.0 (- C■05 ( l_(--
PROPERTY OWNER MAILING ADDRESS E-MAIL
c ,)( 3 75(A
CITY STATE ZIP
53c,-,1( I 0 1-3-795s-
.
NAME PHONE
(\iLC- ' YS TL r. 0C- 1' i a tOC.. . 1-'63- `633-iz`i``
MAILING ADDRESS E-MAIL
CONTRACTOR 1-,,Cp(t C t��k"r44_7(7 ?