The URL can be used to link to this page

17-100125 ecravED ` 9 7 PERMITAPPLICATION CITY OF ,... JAN U 2011 6,nBPERMIT CENTER+ '�' h dl W , A 8006 Federal Way Cm OF FEDI�MP.. 835-2607 +33325 FAX 253-835-2609S8AvenueSout+per+mFeitcenteeraacityoayWffeder9alway.com3- 325 MOP PERMIT NUMBER- 2 - - 1 O V 1 Z _ _._- //R_/ TARGET DATE T 7/g SITE ADDRESS v}.,�© /� /� '1 SUITE/UNIT# t r 3 f 2- $-t! 'Y- of t ial r UY? J 4l/ 2 PROJECT V• A ON ZONING `___ ASSESSOR'S T /PARCEL# $ cad 0 . 0_ i - 9 -2 % 4 E OF PERMIT 0 BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING u4 FIRE PREVENTION NAME OF PROJECT �,,n l _,, PROJECT DESCRIPTION a Sp3 Yft`el Aai i up Detailed description of work to o be included on this permit only N"eE �. PRIMARY PHONE OU.it a_ r. c 3—3 3z-4jS"z-7 PROPERTY OWNER MAILING ADDRESS E-MAIL 92-2- 3 3` C+` 1ludrvlyIaevans i ib C TY STATE ZIP i3P{'YJ NAME p lasG1j"_j_) PHONE - i A o"i�- I ,E ,i, e.( ltiems'!J_$a f3---Z7 6--/2_7‘, MAILING ADDRESS E-MAIL CONTRACTOR ' -4key1(kit 0 CITY 1 .'STAA'�STATE ZIP FAX e. 1...et. ce 1144"�(,e (.a a. 97.1121e ectiri WA STATE CONTRA TOR'S LICENSE# stXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# PATAi1= D99cF= lq-/-fof9gg- oo, 8z NAME� tt PRIMARY PHONE d ®P-P) elF4 F zC 3--3 S 2--1(-c 2 APPLICANT MAILING ADDRESS E-MAIL 92 2 5 zJ 3/3 - C7 kicimyja.i 156 9, CIT STATE ZIP FAX i _'°7 icy -tc1-d- 9B402 NAME PRIMARY PHONE PROJECT CONTACT /..t el icy a_ Ev .24-3- 332- KS--2 (The individual to receive and MAILING ADDRE E-MAIL f respond to all correspondence nz�y�5 /1) 3/.? cr ��j/y } ^mss 1'flfo)I'nfItzefraii /9 i C) /jy� concerning this application) CITY 4e4�C�JL-�'� y�Jdy' STATE t/1/�.i... ZIP �QG,s,] FAX KfLGt'_-"'.7 NAME V `(J� PROJECT FINANCING 10 OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 71C _y 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 Iocal, 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: ��/ - �iJL/�, '�, DATE 1` /(-C? PRINT NAME: 4Za4_ s " a 9. 2,7x-i-i--s Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application I grb VALUE OF MECHANICAL WORK MECHANICAL PERMIT Indicate how many of each type offixture 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(Commercial) 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(Kitchen/Utility) 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...****'LER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? Yes ❑ No o Yes ❑ No R ItQrni NTI A I - NLi'W(1R 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) A {. '/ EXISTING PROPOSED TOTAL Area ea i ota is --_ - *iJEW H011TES ONLY** ESTIMATED SELLING PUCE$ 17017 BEDROOMS COMMERCIAL—NEW/ADDITION AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information Square Feet Type Stories NEW BUILDING ADDITION COMMERCIAL—REMODEL/TENANT IMPROVEMENTS Area in Construction #of AREA DESCRIPTION Square Feet Occupancy Group(s) Type Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100-January 29,2016 Page 2 of 2 k:\Handouts'\Permit Application