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1'. t . .
': Building Division
CITY OF41/4b,
33325 Eighth Avenue South
- ..PO Box 9718
Federal lNayFederalWPhone 253-835-2607
Fax 253-835-2609
CORRECTION NOTICE
ADDRESS: 3 1 809 37294/lye., 5 ,GU. PERMIT#: /a -/D//1".3 -. '6,-SA:----
65 P/C) vC`�� WI k10 r-J €- cZ_s er/# ni, �. 20�A-2—
d- a/sic 7 s --74e 74 7,t/..
O �� 4. f i
A,Gtedi,d1'MI Cti
:'�L 6a 744%7 L)L k u,47
6) R et 04 p ZS kW Lf Ce., j A p (d,c-c., 4,0 rake. Al/SI
G16s5 (37C S/G rs�J ft-pelosjcSj
IF YOU HAVE ANY QUESTIONS CALI-Mag/<(A)af444‹.5 (253) 835- Z f0.2., I
WHEN CORRECTIONS HAVE BEEN MADE, CALL (253) 835-3050 FOR RE-INSPECTION. SEE BACK OF CARD
FOR DETAILS. NOTE: ELECTRICAL CORRECTIONS ARE REQUIRED TO BE MADE WITHIN 15 DAYS.
3 - 3o- /d c. i
DATE INSPECTOR
DO NOT REMOVE THIS NOTICE
Page ( of I
çECEIVERMIT
aAp1.3 I ,AI' CO ME EL PL DE EN FP
COAfMUPATY DEVELOPMENT SERVICES MAR 2 4APPLICATION / 57Tr
253-8352607•FAX 253-835-2609
www.dtuo/kdemtuwu can
SITE ADDRESS
� 3/ fL M
JSe)
SUITE/UNIT a ZONING ASSESSOR'S TAX/PARCEL t
NAME OF PROJECT
(Tenant or Homeowner Name) Ft01^� � �Qti 4 `4-" 1 U
�--
❑BUILDING 0 PLUMBING 0 MECHANICAL A ( 4
TYPE OF PERMIT ❑ DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION V
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME PRIMARY PRONE
PROPERTY OWNER . R ', A - rti (713 )$j' -33
MAILING ADDRESS,CITY,STATE,ZIP E-MAIL
OWNER IS ALSO: p CONTRACTOR p APPLICANT -_ PROJECT CONTACT
NAME PRIMARY PHONE
CONTRACTOR MAILING ADDRESS,CITY,STATE,ZIP
WA STATE CONTRACTOR'S LICENSE• EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE i
/
NAME PRIMARY PHONE
APPLICANT
MAILING ADDRESS,CITY,ST*TE,ZIP f '
PROJECT CONTACT RARE PRIMARY PRONE
(The individual to receive and mi `j •s 3 - St
respond to all correspondence MAILING ADDRESS,CITY,n :T ZIP 11111111i11111111
concerning this application) 1 N r
ALTERNATE CONTACT NAME: PRIMARY PRONE E-MAIL
1- act' ' ii 3
PROJECT FINANCING NAME
OWNER-FMANCED
Requiredfor projects Cts with [�
value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PRONE
(RCW 19.27.095(
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certify that to the
best of my knowledge,the information submitted in support of this permit application is true and correct.I certify that I will comply
with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit.I understand that
the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred
in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the
city,but only when such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied ., the city as a part of this app -,,. n.
SIGNA t - 4011.4111 �L7 DATE
PRINT NAME: — ` A
Bulletin#100—6/29/2009 Page 1 of 4 k:\Handouts\Permit Application
AfEellitNICAL FIXTL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED)
Indicate number 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(commercial)
BOILERS FURNACES HOT WATER TANKS)Gey
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING FIXTURE
Indicate number of each type of fvcture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
BATHTUBS(or'hrb/sower Combo) LAYS(Hand siolce) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS(lticoben/uwi WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
$ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes 0 No
RESIDENTIAL
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL
FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT 0
OTHER(describe)
EaSraG PROPOSED TOTAL
Area Totals
**PIETY HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL -NEW/AD►DIT'IO1
AREA DESCRIPTION Area Construction •of
in Square Feet Occupancy Group(s) TypeStories Additional Information
NEW BUILDING
ADDITION
COMMERCIAL= REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area Construction #of
in Square Feet Occupancy Oroup(s) , Stories Additional Information
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—6/29/2009 Page 2 of 4 k:\Handouts\Pennit Application