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07-104949 41/ -. 5 CITY of Ai, ��c�, l/ 1 V q Federal Way PERMIT SEF 0 I 2.QQ SF MF CO ME EL PL DE EN 41. COMMUNITY DEVELOPMENT SERVICES 33325 DERALNUE SOUTH•PO B0X 9718 �AT ,LI C ATI O N / / FEDERAL WAY.WA 98063-9718 r � 253-835-2607•FAX 253-835-2609 ��LL www.cifyo federalway.eorn torn`ft ©e?�r The following is requirecPinformation-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION SITE ADDRESS 33414 21st Avenue SW SUITE/UNIT#_ ASSESSOR'S TAX/PARCEL# 1 3 2 1 0 3 - 9 0 6 2 LOT SIZE(sJ) 2.27 acres LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) See Attached (Attach separate page for lengthy legal description) NI PROJECT INFORMATION TYPE OF PERMIT N BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERINGXe. IRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit onlg) �i�G ,e)C 4 j� `� Replace existingfire sation en rator with a 135kW dieselgenerator and u ll fuel tank. Generator r l e n e utdoors on an extended ement pad within a fenced enclosure and will be shared b the fire station and the existin• wireless facili - _ --- VeeiZar _ CI PROJECT NAME(Name of Business or Owner Last Name) SEA Mirror Lake • PEOPLE INFORMATION PROPERTY NAME PRIMARY PHONE OWNER King County Fire Protection District#39 ( ) - MAILING ADDRESS CITY,STATE,ZIP E-MAIL ADDRESS 33414 21st Ave SW Federal Way,WA 98023 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE Boss Construction ( 253 ) 863 - 3881 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE PO Box 251 Pacific,WA 98047 ( ) - .'f' , CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER 7. , / '. 20-05-101963-00-BL ( '2. _' 1- o-7 ( ) - COPY of card reai /� ' CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS .11 with each appliat,oi , I''• BOSSCSL981C2 02/22/2008 '\,__---/ APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE Verizon Wireless Jennifer Taylor ( 425 )274- 4444 ext141 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE 14432 SE Eastgate Way Suite 260 Bellevue,WA 98007 ( ) - RELATIONSHIP TO PROJECT FAX NUMBER o Architect o Tenant NAgent 0 Other ( 425) 274- 4449 PROJECT NAME PRIMARY PHONE E-MAIL ADDRESS CONTACT Jennifer Taylor ( 425) 274 -4444 ext. 141 jtaylor@realcomassoc.com LENDER NAME Per RCW 19.27.095: N/A Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - • DETAILED BUILDING INFORMATION EXISTING USE Fire Station and Wireless Facility PROPOSED USE No Change EXISTING ASSESSED/APPRAISED VALUE$ Unknown VALUE OF PROPOSED WORK $ 13,000.00 SPRINKLERED BUILDING? o YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? 0 YES M NO WATER SERVICE PROVIDER D. LAKEHAVEN o HIGHLINE D TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN o HIGHLINE ❑ PRIVATE(SEPTIC) r ■ PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT Unknown No Change N/A FIRST N/A Unknown No Change SECOND Unknown No Change N/A THIRD Unknown No Change N/A ADDITIONAL FLOORS(DESCRIBE) N/A N/A No Change DECK(❑COVERED OR ❑UNCOVERED?) N/A No Change N/A GARAGE ❑ CARPORT ❑ / N/A N/A No Change EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF NUMBER OF FLOORS Unknown No Change Unknown **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ • 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 UNITSEVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERSFIREPLACE INSERTS HOODS(Commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub shoU-ereom o) IAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYSTVACUUM BREAKERS DRINKING FOUNTAINSSHOWERS WATER CLOSETS(Toilet) 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 rel'ance 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 _ _ 4 , / DATE 4/1/07 IF (Sig, ture) / Alen-E- RELATIONSH ' TO PROJE ❑ Owner A.Agent ❑ Contractor ❑ Architect ❑ Other ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? n YES ❑NO ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO PLATTED LOT? ❑YES o NO DEMO PERMIT REQUIRED? ❑YES ❑NO Bulletin#100-April 2,2007 Page 2 of 4 k\Handouts\Permit Application