07-104120 CITY OF uO" • art_ — —LA— �`
Federal way PERMIT
COMMUNITY DEVELOPMENT SERrt1 ECEt V ED SF MF CO ME EL PL DE EN Ej
3332 8T"AVENUE SOUTH• 78
FEDERAL WAY,WA 98063-9718
A P P L I C A T I O N
TD
253-835-2607•FAX 253-835-26092 5 2-U / /
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The following is re uire. r AIAYzn incomplete application will not be accepted. Please print legibly(in ink)or type.
1 .. 6 *T- 8
■ PROPERTY INFORMATION
���^
SITE ADDRESS_ ,2 Oil S. �Q/��fl'1c fl� SUITE/UNIT# C-6
ASSESSOR'S TAX/PARCEL# - LOT SIZE(sf)
LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1)
(Attach separate page for lengthy legal description)
III PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
❑ DEMOLITION 0 ELECTRICAL ❑ ENGINEERING XI FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
Relocate 3 heads
Plug 1 head / 61,1- 4.., -‘654c-0/ -
.
PROJECT NAME(Name of Business or Owner Last Name) In to Juice
MI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER Steadfast Companies ( 949) 852 - 0700
MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS
4343 Von Karman Suite 300 Newport Beach, CA 92660
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
Crown Fire Protection, Inc. Jessica Robinson ( 425 ) 481 - 7669
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
P.O. Box 12113 Mill Creek, WA 98082 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
7380 ( 425 ) 481 - 8695
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
COPY of card required
with each application ' CROWNFP044LL 4.8.09 jessica@crownfp.com
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
SAME AS CONTRACTOR ( ) -
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑ Tenant 0 Agent X Other Contractor ( ) -
PROJECT NAME PRIMARY PHONE. E-MAIL ADDRESS
CONTACT Jessica Robinson ( 425 ) 481 - 7669 jessica@crownfp.co'n
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS - CITY,STATE,ZIP PHONE
( )
■ DETAILED BUILDING INFORMATION
EXISTING USE Retai 1 PROPOSED USE Retail
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $$650.00
SPRINKLERED BUILDING? X YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES ❑ NO
WATER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE 0 TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC)
EXISTING PROPOSED
AREA DESCRIPTION O
. TOTAL
BASEMENT '
SQ.F. SQ. FT. SQ. FT.
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE) .
DECK(0 COVERED OR 0 UNCOVERED?)
GARAGE 0 CARPORT 0
NUMBER OF FLOORS E715050 PROPOSED TOTAL TOTAL EXISTING Sr TOTAL PROPOSED Sr TOTAL Sr
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
a FIXTURES
Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS FANS GAS WATER HEATERS MISC(Describe)
•
BOILERS FIREPLACE INSERTS HOODS(commercial)
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SETS REFRIG.SYSTEMS
PLUMBING
BATHTUBS torTub/shower combo) LAVS(Bathroom sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(roue)
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 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.
NAME/TITLE / /e4'7JC _ i t `!Yr 1 DATE 7/2-3/07
(Signature) (Title)
RELATIONSHIP TO PROJECT 0 Owner 0 Agent „ Contractor 0 Architect 0 Other
a NEW o ADDITION ❑ALTERATION o REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? o YES o NO
PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-April 2,2007 Page 2 of 4 k\Handouts\Permit Application