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16-105371 RECEIVED 'PLICATION [OF PERMIT Federal Way Nov 07 2016 / OFF FEDERAL WAY PERMIT NUMBER /49 / S C' 7 ` - F E TARGET DATE (7......---.....s.....'s.....----j SITE ADDRESS J i,e0 5`,+W" ,, yy, �i QD r, SUITE/UNIT N Federil` gWb23 PROJECT VALUATION ZONING ASSESSOR'S 11 $ go 1�� 1 ,72_ 0 - 0 7 / TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION NAME OF PROJECT S i - 4,, i,,5 i,c:.. u, .„, , c%` alit~,1 toetc ikyi. caj t t,& , PROJECT DESCRIPTION I I Detailed description of work to 3 LAp p(e551 O:'\ 5/5' es- 1 f Fr -- )i N c. L OFn�1 eiri i-( 14 rf' tev I be included on this permit only +YPe1_ NAME PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL i CITY STATE ZIP NAME V��'1 C lye ,1 r/( j1}..�/y, PHONE 733__30 60 e. MAI -- -DDRESS ( / E-MAIL CONTRACTOR •rr.0 7Iy /4 C�7.tr(� el', I(Ar l vl a say) s�'-Cf .c� CITY i 1 / ST E ZIII - FAX '- '',A kwi I�4_ , f ,�/,d 2-- err- 6-3/ WA STATE CONTRACTOR'S LICENSE S EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S SANOE FPC445D/V 3 / 15 / 18 2b-1( -101894-000-at- NAME PRIMARY PHONE Ccxry 0V07 111 253-70t-7tig APPLICANT MAILING ADDRESS E-MAIL /12° .FICOU VI Pot.,t Vkia Celery u301Verion3Orcu I, -•.A CITY STATE ZIP FAX LJ L `j' `12Z 2S -277-1531 .. ... NAME ., ._. PRIMARY PHONE PROJECT CONTACT D4 I( Le,r 1 Se's 24y,- Fjc1qY 66 L 17 (The individual to receive and MAILING ADDR S 1 E-MAIL respond to all correspondence 11-1 t V d A t j J. clt-o- - t.1 6 5f,kfi rccq' concerning this application) CITY STATE ZIP FAX 1LLtkkAl Ile. Wet, (` i 116 453 -277 15 3/ NAME PROJECT FINANCING ❑ OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. 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, but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city • -a part o this a•plication. 1 Cr" " it I©/2/!J 4 SIGNATURE: DATE PRINT NAME: C..et9 D tier 1 • Bulletin#100—February 22,2016 Page 1 of 2 k:Wandouts\Permit Application • • VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(Commerc■al) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain. BATHTUBS(or Tub/Shower Combo) LAVS(Hand Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitrhen/utiiity) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes❑ No X Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER(describe) Area Totals EXISTING PROPOSED TOTAL **D?HOMES ONLY" ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL—NEW/ADDITION Area in Construction #of AREA DESCRIPTION Occupancy Group(s) Additional Information Square Feet Type Stories NEW BUILDING . ADDITION COMMERCIAL—REMODEL/TENANT IMPROVEMENTS Area in Construction #of AREA DESCRIPTION Occupancy Group(s) Additional Information Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—February 22,2016 Page 2 of 2 k:\I-Iandouts\Permit Application