06-104251 RECEIV. 9 , 2 _ ( c)._ 4-( *Z- -5-1
Federal Way PERMIT
COMMUNITY DEVELOPMENT SERVICES
33325AVENUE SOUTH•PO BOX 971
�4UG 2 2 Zit)
SF MF CO ME EL PL DE EN P
p L I C AT I O N TD
FEDERAL WAY,WA 98063-9718 / /
153-835-2607•FAx2s3-83s-24Qyr�i OF FEDERAL WAY
wwwcityo((ederalway.rnm
BUILDING DEPT.
The ollowi • is re•uired in ormation-an incom•lete a••lication will not be acce•ted. Please •rint le•ibl in in or .
• PROPERTY INFORMATION
SITE ADDRESS _3542$ Way, WA SUITE/UNIT#
ASSESSOR'S TAX/PARCEL 4011111116241111111116, #2921049077, LOT SIZE(sf) _17.62 ac.
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)_See attached sheets (2)
(Attach separate page for lengthy legal descrip ion)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL a ENGINEERING iI\FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
Water Plan and Details - Underground Fire Sprinkler permit application
PROJECT NAME(Name of Business or Owner Last Name) _Lowe's of Federal Way M10.S4._
NI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER Lowe's HIW, Inc. ( 760 ) 804-5300 -
MAILING ADDRESS CITY,STATE,ZIP
1530 Faraday Avenue, #140 Carlsbad, CA 92008
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CONTRACTOR gOOMPANY NAME APPLICANT NAME
v3L t €,(. viOFFICE PHONE
-Mal -65-8531 -le
a
MAILING ADDRESS CITY,STAT ZIP CELL PHONE
•: . •- „••• i ••e H_illsbor_o OR__97124 (.50-3 )- 969=5-107._..
`/ CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER -
V` — — — / I ( )
B L
CONTRACTOR'S REGISTRATION NUMBER(copy of card required with each application) EXPIRATION DATE
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
PACLAND Paul Manzer ( 425 ) 453-9501
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
11235 SE 6th Street, #220 Bellevue, WA 98004 ( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant X Agent ❑ Other(Describe) ( 425 ) 453-8208
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
Jenelle Taflin ( 425 ) 453-9501 jtaflin(a,pacland.com
LENDER .F. >7.?
' , NAME
" :'' Lowe's HIW, INC.
MAILING ADDRESS CITY,STATE,ZIP
1530 Faraday Avenue, #140 Carlsbad, CA 92008
• DETAILED BUILDING INFORMATION
EXISTING USE Commercial/Retail PROPOSED USE Commercial/Retail
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 16,317.00
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL)
•
• SEWER SERVICE PROVIDER ❑ LAE N 0 HIGHLINE 0 PRIVATE(SE,
r ‘
f PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE ❑ CARPORT❑
NUMBER OF FLOORS
EXISTING PROPOSED TOTwt TOTA S7LtsTibOSF 'TOTi�..�SF TOTAL SF ; 1"
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATI C LERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(Commercial) WOODSTOVES
BOILERS FIREPLACE IN RTS RANGES MISC(Describe)
COMPRESSORS FURNACES /\. GAS WATER HEATERS
DUCTS GAS PIPE OTL S
PLUMBING /
BATHTUBS(or Tub/Shower Combo) SHOWEI4S WATER CLOSETS(Toilet) MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS(Bathroom Sinks) VACUUM BREAKERS ELECTRIC WATER HEATERS
DISCLAIMER/SIGNATURE BLOCK
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,but only where such claim
arises out of the e of/the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of
this applicatio 7,
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NAME/TITL .,/' ` PACLA�VD f-S$o "1-r — DATE O "'2 2—64
(Signature( of/ 1 (Title)
RELATIONSHIP O P )ECT 0 e er Agent 0 Contractor 0 Architect 0 Other
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Bulletin#100—January 7,2005 Page 2 of 4 k\Handouts\Permit Application