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15-100808 ., • wilding - Single Family CommunityCof Federal �oev.Services Permit #: 15-100808-00-SF 33325 8th Ave S Federal Way,Fax 98003 Inspection Request Line: (253)835-3050 Ph:(253)835-2607 Fax:(253)835-2609 Project Name: SIX STAR ELDER CARE Project Address: 31801 8TH AVE S Parcel Number: 609400 0005 Project Description: ALT-Verification of Occupancy for Adult Family Home. ***No construction work allowed under this permit.*** Owner Applicant Contractor Lender DINA GRIB DINA GRIB 31801 8TH AVE S SIX STAR ELDER CARE FEDERAL WAY WA 98003 31801 8TH AVE S FEDERAL WAY WA 98003 Census Category: 434-Residential alt/add-no change in number of units Includes: #1 #2 #3 #4 Occupancy Class: Construction Type: Occupancy Load Floor Area(sq.ft.) 0 0 0 0 Additional Permit Information New/Additional Sq.Feet-3rd Floor 0 New/Additional Sq.Feet-Basement 0 Mechanical to be Included No Plumbing to be Included? No No Fixtures Associated With This Permit!! PERMIT EXPIRES Wednesday, August 19, 2015 Permit Issued on Friday, February 20, 2015 I hereby certify that the above information is correct an. -- -- -:•- taction-on.the above described property and the occupancy and the use will be in accordance with the laws, . -s and regulations of the State of Washington ..,._,- -, and the City of F-deral -y. _ Owner or gent: ; Date: 0 z © " `L5 CITY OFA • PERMIT MF CO*�'MEE PL DE EN FP JIVED COMMUNITY DEVELOPMENT SERVICES APPLICATION 253-835-2607•FAX 253-835-2609 w<<;w.cmp,�!ece rziu ali,cu,r FEB 2 0 2015 - SITE ADDRESS I IIP IF' 7! A SUITE/UNIT# 3/g(v/ gni/6 s /- e>z U'C `d.- //9 ` 3 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# ` D9 ({ 0 6 - ►!:UILDING 0 PLUMBING 0 MECHANICAL TYPE OF PERMIT 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT 0 a � A 1 (Tenant Name/Homeowner Last Name) f (_ PROJECT DESCRIPTION Detailed description of work to be included on this permit only NAME PRIMARY�'�+ • PRIMARY PHONE PROPERTY OWNER `"" / /rr Ge (�'R i.13 ,204 g-367-3 ,'z y CITY STATE ZIP NAME N PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# / / MAMB-�-T•e • >A Xi? i� PHONE APPLICANT MAILINGN/G AAD)DRESS (� n/ /P E-MAIL CITY STATE ZIP FAX PROJECT CONTACT NAME PHONE (The individual to receive and respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) CITY STATE ZIP FAX ALTERNATE CONTACT NAME: PHONE E-MAIL PROJECT FINANCING NAME ID OWNER-FINANCED Required value of$5,000 or more (RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE 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 to the city as a part o this application. -7. / SIGNATU '"rt e.:-- DATE CV /ti i PRINT N E Bulletin#100—April 14,2010 Page 1 of 3 k:\Handouts\Permit Application