The URL can be used to link to this page

09-103990 .� X11 uth King Fire Res Approved 6100 r CITY OFPIAFAE /�/d ;i�/[ ©—F— - 1 33 Federal l0 'il ert fits details.; SF MF CO ME EL PL DE EN/®/ COMMUNITY DEVELOPMENT SERVICES 33325 8'''H AVENUE SOUTH•POB 9718 FEDERAL WAY,WA 9•PO T 1 2 U 0„ A - / / 253-835-2607•FAX 253-835- ... ` i ce"`¢""""""" '-"g"'° www.ci(Lolfederatwat.com Date . /-.. The fo Si is g CtEg i iTV • • complete ,pplication wil not be accted.-epPlease print legibly(in ink)or type. • PROPERTY INFORMATIOONN 1 ' .�3 � 644AO 6 SITE ADDRESS -`_ v t V J J J KJ ' — /tile TE/UNIT#_(02. ASSESSOR'S TAX/PARCEL# v. ;--L[e y (1 bC V�.)''10 LOT SIZE(sfi LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) (Attach separate page for lengthy Legal description) ■ PROJECT INFORMATION TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING g FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu) T=. -F :re. 0%,I,arIM l f ;,P1 ! a461e- Cis PROJECT NAME(Name of Business or Owner Last Name) a . 1(� • PEOPLE INFORMATION PROPERTY NAME f PRIMARY PHONE • OWNER A L `: i ✓bl p. 0 t•1 ( ) - MAILING ADDRESS ii, k C ,,,,STATE.ZIP E-MAIL ADDRESS CONTRACTOR COMPANY AME ‘ . APPLICANT NAME OFFICE PHONE Ale r/Cf/ i .•QGur79 FEhc. ( 2S3) ( 3 ,9 - /79Z ADDRESS CIAt CELL PHONE I `' .8 1111 Kn/w— ` kikwOvt/z. II - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EEXPIRATION DATE , FAX NUMBER 6(0-16o 16-5-oo- Et., /�-3/-09 (2-S3) P30 -639(v CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS yne,r► ase-OA,)-as -30- ' APPLICANT COMPANY NAME '� pp i APPLICANT NAME OFFICE PHONE S(L'i�"� Q Ci..)c 0000V.6 ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect 0 Tenant ' Agent Other ( ) - PROJECT NAME PRIMARY PHONE c� ^�G E-MAIL ADDRESS CONTACT Sc O H a -( S (253) G3 7J- (7q[ Z me,e/dia 4sect,ri'ij•4o!', LENDER NAME ` Per RCW 19.27.095: SW""..K► 4Z5 Gl,be 01- Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) • DETAILED BUILDING INFORMATION EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $Viso 04 0 0 SPRINKLERED BUILDING? X YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES 0 NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 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 ❑ NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF **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(Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Nb/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 /J O Property Owner and/or Authorized Agent o NEW o ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT _ BUILDING SHELL ONLY? n YES ❑NO BASIC PLANo YES o NO ZONING DESIGNATION CHANGE OF USE? o YES ❑NO NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? „y e u YES sc NO PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—January 1,2009 Page 2 of 4 k\Handouts\Permit Application