09-100866 ,A, RC IE 109 _ loo �
fe�deral way PERMIT
COMMUNITY DEVELOPMENT SERVICES MAR 0 9 2t)P SF MF CO ME EL PL DE EN6
33325 8Th AVENUE SOUTH•PO BOX 97]8 p CATION TD ((���5//
FEDERAL WAY,WA 98z j$, _ L ,,l 4 / /
253 835 2607•FAX 153 35 'dE/ 1Y)1Yi./I'dT
WWII,.cituoffedera(wau.com c
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
• PROPERTY INFORMATION
SITE ADDRESS 3 6 0 O SOUTH 344TH STREET, FEDERAL WAY, WA 98001 SUITE/UNIT# //D v /o
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf1
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
El PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlu)
PROTECT THE SERVERS ROOM 216 ON 2ND FLOOR BY NE%`REACTION SYSTEM
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PROJECT NAME(Name of Business or Owner Last Name' /KS Cat II (fit 1 e1' /l
• PEOPLE INFORMATION
PROPERTY NAME ) PRIMARY PHONE
OWNER BOB KUBICHECK / (949) 955 - 9397
MAILING ADDRESS CITY,STATE, E-MAIL ADDRESS
17901 VON KARMAN AVE #950 IRVIN CA 92614
CONTRACTOR ct CGzSeo rifQr PRora •nod^ , J#QAS ,QHa ----r.•PHONE
Nines -- }BL-11 ..��_. J Ge'4.317
Lr••••*,r,AnDRESS -�, ` -� �"•""'•' "^— CELL PHONE
1/i`c� c.7cBd�nui7/rte �C'Cc tie (�c��o get tom%' ,? () -
�CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER , /
14` sCl -- c/ °-/cleSr - do - 81_ (�'"#_) 427 - 7(77`
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION ATE E-MAIL ADDRESS
4. ere_Sa rf ,,o hti ice/ / F;10/ d-hc)Co tco F re,Co-n'1.
APP LICF7r COMPANY NAME APPLICANT NAME OFFICE PHONE
COSCO FIRE PROTECTION INC DENNIS RHO (425 ) 686 - 6300
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
15000 WOOD-RED RD #B-800 'WOODINVILLE, WA 98072( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
❑ Architect ❑Tenant ❑Agent ❑ Other SUBCONTRACTOR (425 ) 8 2 7 - 7474
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT DENNIS RHO (425) 686 - 6300 DRHO @COSCOFIRE.COM
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE 1
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 16, 839 . 0 0
SPRINKLERED BUILDING? 'YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑COVERED OR ❑UNCOVERED?)
GARAGE ❑ CARPORT ❑
EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INSERTS HOODS(Commeretal)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks( URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 as a part of this application.
SIGNATURE: DATE T/d
Property Owner and/or Authorized Agent
❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application