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10-101829 •1111116 •o - LL2 CITY OF PERMIT SF MF CO ME PL DE EN FP Federal Way _ _ COMMUNITY253-835-2607* AX 25 835209 APPLICATIOA14',. .'\-1-:<-:-'' ,,, ' www.cituoffederalwau.com .//�../ Preremi SITE ADDRESS p SUITE/UNIT# Sys/5 / �� f�✓c �. rico, a • A.44.45.4.4'S PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ 8, 2.a23•°t 5 a L/ 5 l - a © ,2o TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL ❑ DEMOLITION 0 ENGINEERING ,43fIRE PREVENTION NAME OF PROJECT / (Tenant Name/Homeowner Last Name) F`'a ri�+ 5 Q S�t'Aa„l • N A<S e�-� iee`no�{e PROJECT DESCRIPTION Iris itR,l I TI•Arta,laa yl c y SfeliY� • S`- FYGtM!'.1 S UO SD//UI S-e*, Detailed description of work to le o.enOG(e?I • a n d floor--. Jo%4171 VPN - re h,*iweeh be included on this permit only S;`rplvxCrvinIIe/l avid .720eripsoh elccfYica,I. NAME PRIMARY PHONE PROPERTY OWNER Franc;seam flea/141 cS,S�"� ' W MA/q ING ADDRESS So u.41 ".1 „ c1 Y e-- E-MAIL CITY STATE ZIP `1P105Taco en". 0 1 NAME PHONE ThobS,Psoil a/l b-ie4/61,1.i5- Lib's /nc 6753 • 539•o4147 MAILING ADDRESS E-MAIL CONTRACTOR Po Box `/52('0 o q CITY STATE ZIP FAX Tacof'rIa /nl/9 WI i 5 WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# T iOMPecooSel^/ 2 / r4 / <Z 400/1Oa%/00& NAME PHONE 51ivl pleK6-1-1,,P,e l l 2cio'aq/• <YOe APPLICANT MAILING ADDRESS E-MAIL g52a /j,) Ave S. , Sail-e /ov CITY ,-, L T It STATE ZIP FAX U./Ii) 481 o$ ao 6 •211 •/500 PROJECT CONTACT NAME PHONE TAhct Ste-66,:Yl5 /5midit' n.-,••11 C106.24/•/if6r (The individual to receive and respond to all correspondence MAILING ADDRESS {'fes p r E-MAIL concerning this application) gs2o /P /4'e S. ,Jwr d /� ,e 4•,.4P I5 G5.1�.,/,1ax7ri0rita.eeft, CITY Sc a • STATE ZIP FAX WA- 9S/08' .706•all-/5oO ALTERNATE CONTACT NAME: PHONE EMAIL PROJECT FINANCING NAME 0 OWNER-FINANCED Required value of$5,000 or more (RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE 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.li " �� SIGNATURE: !i / /�Y Jr!'mym7) lc •4-#1 DATE 5/✓5'//cD PRINT NAME: ../A',lei. �L bio;friS ✓ Bulletin#100—April 14,2010 Page 1 of 3 k:\Handouts\Permit Application 204 — all-1 yva • • • MECHANICAL FIXTURES VALUE OF MECHANICAL WORK $ (a copy of bid or estimate must be provided) Indicate how many of each type ofjixture to be installed or relocated as part of this project. Do not include existing factures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial) BOILERS FURNACES HOT WATER TANKS pas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING FIXTURES Indicate how many of each type offixture 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 SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes 0 No ❑Yes 0 No RESIDENTIAL --NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE 0 CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals '.''•*NEW'HOMES ONLY" ESTIMATED SELLING PRICE$ #OF BEDROOMS MMERCI; E /ADDITION ` AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information in Square Feet Type Stories NEW BUILDING tip dial I r J ADDITION COMMERCIAL R MOnEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information in Square Feet Type Stories TOTAL BUILDING i" TENANT AREA ONLY PROJECT AREA ONLY ',':,',-,4,1,'1::1 !r • , ' pn i¢ify .. 4 1 ill Ii . „ o, Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Application