15-105092 Ili
REIVED
CITY OF A PERMITTiPPLICATION
Federal Way OCT 0 6 2015
• CITY OF FEDERAL WAY �
PERMIT NUMBER 1 5 _ 1 I'1 §DS () 9 2 _ l j
P
V — — — — — — TARGET DATE
SITE ADDRESS
SUITE/UNIT#
—5/9/,' o ne • 5 • 3Rwi
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING k FIRE PREVENTION
NAME OF PROJECT 4*— {/2-1— 7 (4 3 4
PROJECT DESCRIPTION Titjtxil /mi l/ `/0 ' Pi
Ay> „,,,,ei
rex aZa/5
Detailed description of work to 4-h/L' /ie . Q i . 5/ <''i/Cfc h- Jf c'y_tis �� 60 f
be included on this permit only p4/p d4 l/ ei/I Ng5 i4,1 3;j e q Je/ , N`/ J® D flo p 5
duff 611.°'( f�X.tt`7r1•lr10 •- it L/9/ Li<4 e5, /+
NAME PRIMARY PHONE
PROPERTY OWNER 14- Mot-if
MAILING ADDRESS E-MAIL6 /b3 CITYov,V` , 8I/ f -
, ZIP_.m , 5 /
NAE
poisfv-e4"r SP76= l''6-34'i
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MAILG� �2av� �,. CONTRACTOR � S ZU �, RL �[0ls4C "
.„,
oddln 0(/.( 7
FSS,_ 5 _37x-3
7T+Q . 77 LI $$#Ic 1 ®/�� FEDERAL WAY BUSINESS LICENSE#
NAM/EF-n Q C .t S(J / 6 PRIMARY PHONE
APPLICANT MAILING`/ADDD LRESS E-MAIL
CITY STATE ZIP FAX
HAMS -rL,a 4 5-=
11111
•
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(commercioq
BOILERS FURNACES HOT WATER TANKS(Gan)
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(Hood 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(Ia Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
r
illFIRST FLOOR(or Mobile Home)
SECON;i�R;
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER.
EXISTING PROPOSED TOTAL r, ..............
Area Totals
"-taw
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
Area Construction #of
AREA DESCRIPTIONOccupancy Group(s) Additional Information
,Type,
is Square Feet Stories
NER►BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area Occupancy Group(s) Construction #of Additional Information
in Square FeetTy11e
Stories
7A[aIGx'
TENANT AREA ONLY
Bulletin#100-January 1,2013 Page 2 of 3 k:\Handouts\Permit Application