08-101856 ,� RECEIV D 1
CITY OF (� 0 k C.
Federal Way APR 18 2008 `� .�L
PERMIT SF MF COMEELPLDEE
COMMUNITY DEVELOPMENT SERVICES
33325 8�FEDERAL AVENUE
WAY.WA 9 SOUTH 1 Lb F FE D ARIMI "ATI O N
253-835-2607•FAX 253-835-2609 s.�
wu,w.cwttoffederaiwatl com CDS ,.
The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type.
n • PROPERTY INFORMATION
SITE ADDRESS .34-i5 00
C-% F►C Hu"( S SUITE/UNIT#
#
ASSESSOR'S TAX/PARCELO O I Q ..2,. 00 - 000 LOT SIZE(sf)
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1)
(Attach separate page for lentAny legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING J$4 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work inciudcd on this permit onto)
ULSOC> CO ' PL►PrhrT K tTCNEN F IRE SUPPRESSIc IJ S Y.S-reivt fiVSTRLLfr-T7otJ
RE_PLAc,)NG CLD Non) CiwvtPLlA T SVSTEPn
PROJECT NAME(Name of Business or Owner Last Name) S E C-C M A- LA-N ES
MI PEOPLE INFORMATION
PROPERTY NAME PRIMARY PHONE
OWNER SEco onA- L.PKJES / ELLOOD QOGKWELL (0753) 937 - O(o//
MAILING ADDRESS CITY,STATE.ZIP E-MAIL ADDRESS
3y5o0 PAciFic 14 WY So FE eRAL c y,wA 98Oo3
CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE
ACCE.$S FIRE PRiTEcrioN SvcS,T,ie SRAniivoNGlF/c CI{Egd6FF (V.?$ ) 4113 -074c/ '
MAILING ADDRESS CITY.STATE,ZIP CELL PHONE
P o Bo)C t.co( MAPcE vAu.gr,wrr 98'038 (lob) 380 - 6Y512
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
0790-as-/col 7 7- 00 -8L. /s/31/4)8 (44s) Ili 3 - 2GN7
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE EMAIL ADDRESS
ACtrESFP9Li/ F T51/L/09 admr Access-tire.
pPotecfion. conn
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Acc-ESS FARE PRoTF_cnon.) sots,T1.4c_ s1FANNoa&1 rIL C#/E2,0oFF (Ws-) Yl3 -2 4 cig
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
(gyp
E30. MAPLC. uaLL-Ey,, `$'0.3$' (01o6) 3$6 - 4.1/4f2
RELATIONSHIP TO PROJECT FAX NUMBER
❑Architect ❑Tenant ArAgent 0 Other (y.2 s) ,113 - c2-404
PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS
CONTACT ELWOOD ROCkCJEI.L (A53) 927 - DWI
LENDER NAME Per RCW 19.27.095:
Lender information is required(f project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
II
DETAILED BUILDING INFORMATION
EXISTING USE A OW Li N G LANE 5 PROPOSED USE SAM E
EXISTING ASSESSED/APPRAISED VALUE$ N/A VALUE OF PROPOSED WORK $ 02722.SO
SPRINKLERED BUILDING? 0 YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? EYES 0 NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) N/A
SEWER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) N/A
a , , >
■ PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
N/4. SQ.FT. SQ.FT. SQ.FT.
BASEMENT
NJA-
FIRST
N/4
SECOND
N/R .
THIRD N/A
ADDITIONAL FLOORS(DESCRIBE) N/Pr
DECK(0 COVERED OR 0 UNCOVERED?) N/s
GARAGE 0 CARPORT 0 N/t�
�
NUMBER OF FLOORS ,vel PRO5OBm >O
TOTAL TOTALRsTINGSF TOTALPROTSF nsDTOTALS,
"NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture to be installed or relocated as part of this project. Do not find iirk'existing fvctures to remain.
111ECHANICAL
Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST$&INCLUDED WPTH APPLICATION)
AHANDLING UNITS ORATIVE COOLERS„,,�`"- Y
IR GAS PIPE OUTLETS WOODSTOVES
�
BBz9S FANS '-"-tea GAS WATER HEATERS MISC(Describe)
BOILERS FIREPLACE INS . _ HOODS(Commercial)
COMPRESSORS FURNACES � --, RANGES
DUCTS GASG SETS `"RF.FRIG.SYSTEMS
PLUMBING ��
BATHTUBS(orlhb/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS fRAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WAIKR CLOSETS(toilet)
ELECTRIC WATER HEATEI@ SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
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 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. !,
SIGNATURE: v — ANT DATE 7/8/�
Property Owner and o thorized Agent
FOR OFFICE USE ONLY
o NEW o ADDITION o ALTERATION o REPAIR a TENANT IMPROVEMENT
BUILDING SHELL ONLY? a YES a NO BASIC PLAN? a YES a NO
ZONING DESIGNATION CHANGE OF USE? o YES a NO
NEW ADDRESS REQUIRED? a YES o NO UP/SEPA/SU? o YES a NO
PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO
Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application