10-104740r
6, .4... _ep - L _O_V7 0
°e VR€CEIVE?PERMIT SF MF CO ME PL DE EN F�
4
Federal '(� 1
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COMMUNITY DEVELOPMENT SERVICES Aj)pLI CATI O N
253-835-2607•FAX 253-835-2609 Q
www.cttyoffederalway.com NOV V 20 0
SITE ADDRESCI J 1 OF FEDERAL WAY
"" SUITE/UNIT A
1900 S 288het
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL It
10,000 bldg/fence, RM 3 3 2 2 0 4 _ 9 1 5 9
35,000 fuel system
TYPE OF PERMIT N BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT west Federal Way Tank Replacement
(Tenant Name/Homeowner Last Name) Q Q y P
PROJECT DESCRIPTION Replace underground fuel storage tank with aboveground fuel storage tank.
Detailed description of work to $ d �►�1 security fence-at-cant neW an . •
be included on this permit only
PHONE
PROPERTY OWNER NAME James Michael, Qwest Communications PY206--380-2224
MAILING ADDRESS 1208 NE 64th Street, 4th Floor E-MAIL james.michael
CITY STATE ZIP @qwest.com
Seattle, Washington 98115
NAME Michael Muller, Saybr Contractors, Inc. PHONE 253-531-2144
CONTRACTOR MARINO ADDRESS 3852 S 66th Street mmuller@saybr.com
CITY Tacoma, Washington STATE ZIP 98409 FAX 253-536-2068
WA STATCONTRACTOR'S i 6:_s-3L,C 7 EXPIRATION DATE
/� FEDOER WAY BUSINESS 6,
NAME Mark Knoke, KDW PS lr/ PHONE 206-54V7-11940
APPLICANT MAILING ADDRESS 10202 5th Ave NE, Suite 102 E-MAIL markk @kdw.net
CITY Seattle, Washington STATE ZIP FAX F"x 206-547-8212
PROJECT CONTACT NAME Mark Knoke, KDW PS PHONE 206-547-1940
(The individual to receive and
respond to all correspondence MAMING ADDRESS 10202 5th Ave NE, Suite 102 E-MAIL markk @kdw.net
concerning application)
a lication)
CITY Seattle, Washington STATE EIP 98125 FAX 206-547-8212
ALTERNATE CONTACT NAME: PHONE E-MAIL arnoldk @kdw.net
Arnold Kraakmo 206-547-1940
PROJECT FINANCING NAME
Qwest Communications 131 OWNER-FINANCED
Required value of$5,000 or more
IRCW 19.27-095) MAILING ADDRESS,CITY,STATE,ZIP PHONE
1208 NE 64th St, Seattle 206-380-2224
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 p rt of this ica on.
SIGNATURE: DATE '`°4 '�
V
PRINT NAME: �I f� S-4.‘,
Bulletin#100-April 14,2010 Page 1 of 3 k:\Handouts\Permit Application