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16-105128 '"` S PERMIPAPPLICATION CITY OF "�• Federal Way PERMIT CENTER+33325 8th Avenue South + Federal Way,WA 98003-6325 253-835-2607 + FAX 253-835-2609 +perm I,,i':,.:ii.way.com PERMIT NUMBER I (e) - ( 0 ( <j g _ F-p OCT 212016 — TARGET DATE CITY OF FEDERAL WAY SITE ADDRESS SUITI '# 4299oif Pile/plc- fhf 31hym Pervi, n/>Ay PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ L1/� 3 0 &F 0 0 - 0 O 8 1 TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERINGFIRE PREVENTION NAME OF PROJECT )ede int( Nz \/. ike ra KS C et -k e.v PROJECT DESCRIPTION l9vA43ev.avoo Ferre 5DY1 � N Ker Li .& Detailed description of work to 9 be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER MAILING ADDRESS E-MAIL CITY STATE ZIP NAME PHONE Freeman r3e11 Co►te1-. A. bey_ .45 3-2( 8-3`4/5 MAILING ADDRESS A ' q , E-MAIL CONTRACTOR �0 Vali em Awe- / � 5 V !V '� )QY-:Tl'P� 12).aSC'�•�' CITY (�J en✓ STATE ZIP `/��y`.r'��3 Z FAS3 WA SPIE,1 l l.lo. LICENSE# �A ERPIRATI N7 1TE FEDERAL -1BUSINESS 06z- 35 3 CENSE# FR --`tl7,� 3 / lb/ (7 NAME PRIMARY PHONE .'ee. Cb'AA-wackobe- APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX NAME PRIMARY PHONE PROJECT CONTACT 1.--kAi e v r"reewia vA 25 3-2608---3?"` (The individual to receive and MAILING REss ` E-MAIL respond to all correspondence CDC)l Va 11 e t l Ave, Mg 5 J 1 to N 'eV.fvEe Wla..1 Q fix-el•Ce concerning this application) CITY ...� STATE ZIP 21 u. .ja11v� A TS 37 2 253- '1ec4 3353 NAME PROJECT FINANCING ❑ OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 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 t, the city as a part of this application. SIGNATURE: '/4,/ DATE O©-21- I CQ PRINT NAME: / 1(i()e✓ FrEP Mat') Bulletin#100–January 29,2016 Page 1 of 2 k:\Handouts\Permit Application • • VALUE OF MECHANICAL WORK MECHANICAL 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. 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 DISHWASHF.RS RAINWATER SYSTEMS URINALS OTHER(llecrrihr) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERALINFORM_ATION 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? o Yes ❑ No ❑ Yes ❑ No FSIDENTIAL _ NEW OR ADDITION r 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) ................................................................................................................................................................................................ EXISTING PROPOSED TOTAL Area Totals **NEW HOMES oNLY** ESTIMATED SELLING PRICE$ #OF 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 DESCRIPTION Area rea in Occupancy Groupls) Construction #of Additional Information Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\HandoutsWermit Application