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15-103424 j III RECEIVED e JUL14Z015 - HZc/ .0F A* P E R M I, Federal Way OF FEDERAL w Y MP Co ME PL DE EN/ ° COMMUNITY DEVELOPMENT SERVICES APPLI CATI0 htD5 253-835-260.FAX 253835-2609 LL,M lL LdemJunl.coni i_-- -- SUITE/UNIT Y ----�- SITE ADDRESS , 31o.2 -1 1-100 Rd. SIN) PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL S (, 41'1.2 .�. c) .g 5 0 0 - oa o TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING °tS'FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeoumer Last Name) PROJECT DESCRIPTION F'(e Vier't V�1c\L 'T i Sr.i' re-u wC.,W__ __. cit. Detailed description of work to Ge..\.v`. be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL 1 1 1 / 1 C1 CITY STATE ZIP NAME PHONE 'Re 6. Na.•.-14 F'.c t_ ?co\e.c..-.to v-• 2s?- i0-1 7 -S 1C1iJ MAILING ADDRESS E-MAIL CONTRACTOR /Oc'2 N• c t c.A I Av.. S . ,• ' . _ 1 CITY STATE ZIP FAX P�-��‘‘�p W,a 9 'L� t GIt V/1 '7ir WA STATE CONTRACTOR'S LICENSE Y • EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE Y Ivl� (� R_ • v r C CD J /1-.? Rs - .•-u . NAME _._-. JPHONEt�( ' . .r _ `r0 .Y 2 5 ' D ID" Or APPLICANTMAILING ADDRESS CC,,� Q /�^+� E-MAIL 420 2 IV . r\t-c..ok:c.v, ..7TG• TOO t "ex, eteC 1 CITY STATE ZIP FAX Pi.„Act \ i 5 CI 21 1 PROJECT CONTACT NAME�/ PHONE/The individual to receive anti "'� ��j~'a<< 25a-Syo'y9/00 respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) I DO 2_ hJ• 1%1\4-1"'.cKayk, Wt.L• I CJOi \moor• 22-1 Ktv:v%V.Qgzc}.‘rkf (.-FF•co vv., //''�� �/)2/0 ''']]] CITY (`] STATE ZIP FAX i•.L. •7` � 9/.0.,•./SATE ATE CONTACT NAME: w PHO H?: G 6 3 1 1 E-MAIL VVV-1 'F�x 2. 3 ho- L• PROJECT FINANCING NAME [l OWNER-FINANCED Required value of$5,000 or more (RCW 1927095) MAILING ADDRESS,CITY,STATE,ZIP PHONE I certify under penalty of perjury that I an,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 ci as a part` this application_ SIGNATURE: DATE - I 41,it tJ I PRINT NAME: Ki—v.r•. " �‘-'r -- Bulletin 19100—January 1,2011 Page 1 of 3 k:\Handouts\Permit Application d , + ' t K o 1i it, I6 �,•$1 '_ S � r i f J �It t � s •r�� 1 '�5? r '. S � a 4 i � • ijy �°tll.:>i S. ,a r.ls �•s .aa�..�r'�::. •.. 's�dwrr,. ::r,�a,�� ' ,.lt{r�t!#kl' .•a.. >,5 t'u. �' it ," VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided 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. AiR HANDLING UNITS FANS —_ GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS'Comaemia) BOILERS FURNACES HOT WATER TANKS(G..) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING — _ WOODSTOVES r .., ,, IA A�r.� t -, •'Jityi n igirs to IFS 4r� Y Vii_ j"„. + + 1 ` f SKr . 4•'� r t v . fwuQz r `ta litr. All Am L I v� y ,r.. 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 Tub/Shower Combo) LAVS Stand sj,.k t TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS?kitchen/Utility) WATER HEATERS(cieceiq �.,�,�tS�'Qr }.�u HOSE BIBBS SUMPS WASHING MACHINES it`'r_t` fiV fN'I�t•4 NItI'r I)V 1 i 11 r #Y 1 �A q i * { a '�Q�*'�Y i rt1I�,, �il'+ r r.`�, p.. a,- �Y.,�,1 's�ei'lisi:t#��• Vd�A��' " -��'.,. /� ,'. .,�Ca'{� .�. '�£ss )tt{!.'r: 1 .. 1 )la.SLS' At.���. CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE Or EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE tin Square Peet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? '11C,Ires❑ No ❑Yes 0 No 4 .t1` I Mt 11 .1 R H 1 -r "+.`,wryt [S:,b +tlll<'U(ir'�,� ra m ry al7t ,, j„`itt r' 1 +^1 • ? I's; v ;lifi •t ra f_' 2.,ysf E i ,�+ � �>, � y Vii,. 3 i �, f e s 7s• '.� �1i I�I'�t�iI� � • '1 f �i)� r ,S" ai ,_ #It 1 l D ) 9} a. t S clF 1q 1 k' a.,;. n 1n�1 $�.#L,. rt, �r�., f �ixr.+,,i#si.i.,u. tf. Y •.:-tu.9s���+'� i.h. I..,, �..t •'Y;I r tt�.3S ri�.A a,��l�.t. AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE Tar:. mi ,;N�ty, ��f l�'�`� .r,Nl����tsr n ��{��i t`�fl{f i s >,I.�! ''�'�?9''1 r -'S r' :.•i'�- 'a• 91:�i>o�lithi�uStil�i# •. az •7,. i d'. --_______—_._._.._._ FIRST FLOOR(or Mobile Home) r i to :,t•' { ) .. 1,4',44E: G {a A�'il,r� w `lir---------•-_------ -..-..-..-------- - ----- y��;"r';..��aE,�iti�• i�"r va�` ��;`n'd'%`._ ```� �' ,iS`>A�a, ` �.�a ,'� a1, ' '�I`4i�i1 �, �: COVERED ENTRY 4Z40- 6giel i } ' k} +1 , •fu �i� ttt# �fS 5 •GARAGE 0 CARPORT ❑ f�d ; iet .5� ��."� • � ; ��r�l 'i 3p� I��t J�l�yi3,,ff j r t{dr} ,f��'� K i., •�i: . i-TAGi 1-. _.'_.i '., .,' .!!' r I�A .13?'.;i.iii i ,its' 1:$1, EXISTING PROPOSED TOTAL Area Totals uagnieart atiga, LM.„ 1.4._ �47 9ywF7-i214, ii:.MEMO - ----- ESTIMATED SELLING PRICE$ N OF BEDROOMS .), { t• l” '�2 r'I' ! 'p t'?,i#I Ela ..a tJ;;�dia; 1 . . &9yayl t �} n ! 5s' {ii i1 df;!iJa,,' 4, r•t +Pi: Yt ',11p1/4'3410-• t'J , aAll� �. t�.3'tar, 41jy'1,r 114- • r ,n ... .,'1 . trt,w d .. Lug , m, : %... =RI , • i -3. dUa,..nl�•c.i•,01•.D AREA DESCRIPTION Area Occupancy Group(s) Construction •of Additional Information j� in S uare Feet rt!�y •e __ Stories hS'3 + ?`4 t'1 I i + a 4 a�)t}''• i; T) fl y�nrY:1 ?�'�Mi: I# • 1 l=7!R, .' s,y{sk rm+,.Yr• r 1 tr i k} x '.is;i t( f 11 h t t' �� t' 21nu `ri t Fih 3?s3}Ti9 �+G'; t#f }?a '.?•.. 1�'�il��lEi��i{ie:Y.N�rt. 1; $SJu�; c a .ki:t,a�u,1, i1 !t� � I' s1�a. �1aL?�t1'�c.5�;a �u :�zs� � •��ty..:.tiJln4ckkl ADDITION r t r t T•• t R.`n,l'ff tii4 bNfi911 tY11�,•'1 • y it • np # 'f,,�n45 PFt " a s,5t �'Jj • �,.r trx 1 {�� L 2�y, rr 93r 'r3 t �s_.Y Y9���tc,. 1111 �• t:,,. 5111 , ,z• • • � '":",. i "•'av:x} If'i iia$ iiiixiliR • 1 12 ;Il is 't;.i:ir0.'ti + •'t a+.,>E�iRi' atilt. AREA DESCRIPTION Arca Occupancy Group(s) Construction N of Additional Information in uare Feet .e Stories 'Pr'Algae's ^A ." Vi,. �1 f; 0;r1 I,',+;+ -. ilyy�r.'G'4,1-, "• ) i� ;,', i'���' �.Ld.,A �r .0 , w; r ,. 1%.14.1.,,-;"0.1#4,45,41,10t �I; �.,t-• r �^, ,5 ;(,: I I {�• ' 'x'`d%.it1;Y�P.b7 ' .. t.�i .. tis`N S �,....:IhP "«tb Y !'L"YI.'? t iF_..if t I Li.n rh S mtl 'b 7Si` 1 -t.F 4 J .Y6 Y 4igF...an TENANT AREA ONLY V14,11;1411'4 E'!< * �g� "Urq�xm t ,y tj i. a # T1�1.4[?%.� t ie •>Y of �+x• , ,+�fi ql r b � ° At{srlt t yj :i 1+� .-�,y�(L I A`P Or 7 • ' � 1 .' ".t<: .,5.: i I i x�r Yk 9 tfi7 ot:�-. yt'r`,�NN''' 'yam' 1' .tt��t7� 4a'E'!} Sl stML.to`� { 'S`, 'ir, 1!i e �i j , �. '�^3� � `=��..a.. `t` t- r � '31l�iYft '� ,�IV°� I l I�I't� ',�i �";' Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application