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07-100299 RECEIVED COMMUNITY DEVELOPMENT'SERVICES 33530 FIRST WAY SOUTH•PO 130X 9718 � oF .._r JAN 1 9 2007 FEDERAL WAY,WA 98063-9718 Federal way PERMIT APPLICATION--- 253-661-4115•rtFAX:253-661-4129 ' ^ .•...\ fumy.n(4nQederahua 4.Mm Bl 11'W r wg,T, r: // 0 0 , — - f..P TO: For Office Use Only: - / \��GGG IILLLL- "`�yy T/ 'The ollowin. is re.uired in ormation-an incom.lete a..lication will not be acce. -d. Please •rint le•ibI (in ink)or •e. ..' t+ .` Ill PROPERTY INFORMATION SITE ADDRESS: 33(JO 2 a ,rte N w y S. SUITE/APT # A 1410 ASSESSOR'S TAX/PARCEL#: 12 S 21 5 D 1 I O_ ,SQUARE FOOTAGE OF LOT: i I LEGAL DESCRIPTION (e.g.:Acme Estates, Lot 1) r&gr , it' (Atich,1eparate page font� S nlegal desC5ption) .• ■ PROJECT INFORMATION r - .• . _ TYPE OF PERMIT(This application): ❑ BUILDING 0 PLUMBING ❑ MECHANICAL 0 DEMOLITION ❑ ELECTRICAL 0 ENGINEERINCFIRE PREVENTION SYSTEM P•OJECT DESCRIPTION(Provide detailed description of work included on this permit only): A . - b • • SI lees r e r34--; • -A A : 3-e venin ,Y"..• _ . . i - C , mr --.- . .Ir PROJECT NAME(Name of Business/Owner Last Namej: -1 V��� ." ! Sp,. ■ PEOPLE INFORMATION PROPERTY NAME: r PRIMARY PHONE: OWNER I a.iM. (.Z.53) ScC - MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP 33 7�' sirpi_. ..s . PUyIIVP / IVA ?d 37 CONTRACTOR NAME ACOMPANY A OFFICE PHONE: 1 LA r(3 I/ 111 `r` + 1 C e- , ttOreifIo77NG.(253 ) 2Zd - 35,-)43' 35,-)43� MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP " CELL PHONE: 27 7 �G1 Tae^'"^.. wA `�£�4-�4- (253 ) Ift - ?eFS-I- CITY OF FEDERAL WAY BUSIN SS LICENSE NUMBER: EXPIRATION DATE: . FAX NUMBER: - L1-1 L=1 01 1 a a- k2 / -ter low (253 ) 29If- - 3s©, CONTRACTORS REGISTRATION NUMBER: /� (� EXPIRATION DATE: (copy of card required with each application) P 4 T R C i 1 p .09 _I . F 101 3) / 06 LENDER NAME: DAYTIME PHONE: (If Proposed Value>$5,000) ( . ! — MAILING ADDRESS(STREET ADDRESS;): CITY,STATE,ZIP APPLICANT: NAME:,.., COMPANY �y OFFICE PHONE: A r 15 L1 J Is o 1, Pair -Frt, Prale clic",Inc. (253 ) .6 - 2 210 MAILING ADDRESS(STREET ADDRESS): CITY,STATE,ZIP EVENING PHONE: 2707 -76+1' A 16 „,, r (.✓A 9bif-7-4- (253 ) '7726 - 22-90 RELATIONSHIP TO PROJECT: �^ FAX NUMBER: 0 Architect 0 Tenant $-Other(Describe): CO h"1-r&-e--"for. (25-3 ) 2&- - .3c0”? CONTACT PERSON FOR THIS PROJECT: 0 Property Owner Contractor 0 Applicant E-MAIL ADDRESS: 1JI GAris4.1 .. i, &Qa"frt1 4-Ph�.ca, ■ DETAILED BUILDING INFORMATION I &XISTING USE: E+11P4-y R e+0;I PROPOSED USE: AL,"I SG 1(7)1 o- d S1Oc„ EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK: $ 3,/aa SPRINKLERED BUILDING? YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?: 0 YES0 WATER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) • ■ : • • • Z AREA DESCRIPTION EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL BASEMENT l C7 FIRST { 1 J+t`-t & ^I 3 / v SECOND i l /� THIRD FOURTH ADDITIONAL FLOORS (DESCRIBE) DECK(COVERED?) GARAGE/CARPORT HOW MANY FLOORS? TOTAL EXISTING TOTAL PROPOSED TOTAL EXISTING AND PROPOSED **NEW HOMES ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ FIXTURES Indicate number of each type of fixture that is to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work $ AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(Comm ,Q WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) __COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS or Tub/ShowrCombo) SHOWERS WATER CLOSETS(rode) MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYS WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom Saar VACUUM BREAKERS ELECTRIC WATER HEATERS ■ DISCLAIMER/SIGNATURE BLOCK 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: /,1,‘4;1• at e pLC'(',//(otnal er DATE: I /8 T 0 7 (Signature( (Title) RELATIONSHIP TO PROJECT: ❑ Property Owner ❑ Applicant ,S-Contractor ❑ Architect 0 FOR OFFICE USE ONLY a NEW ❑ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT BUELDING SHELL ONLY? a YES ❑NO BASIC.PLAN? a YES a NO ZONING DESIGNATION: CHANGE OF USE? a YES ❑NO NEW ADDRESS REQUIRED? D YES a NO UP/SEPA/SU? o YES a NO • PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES ❑NO 11uL(etin _ tl;: Page 2