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07-100839
t•ederalWay o PERMIT ' S COMMUNITY DEVELOPMENT SERVICE�_' SF MF' CO ME EL PL DE EN + ' 33325 8,"AVENUE FEDERAL WAY,WA T 98063-97897 8�B 1 5 20c1' PPLICATION TD 253.835.2607•FAX 253-835- 1 umt,u.cil,a ederalwan.on itYOF FEDERAL WAY -T-j3-: --� -=3_ _..-7 BUILDING DEPT. The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. / / S PROPERTY INFORMATION SITE ADDRESS 3 `� `r�q v�tJ'"i`r ( S� f�Za j SUITE/UNIT# girl)6 ./T ASSESSOR'S TAX/PARCEL# P ' © i 0 - O U "-1 LOT SIZE(sj) LEGAL DESCRIPTION (e.g.Acme Estates,Lot 1) (Attach separate page for lengthy legal description) ■ PROJECT INFORMATION TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING TIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of work included on this permit only) L) 7r14.1O a 5-76-1-7 C i JS 14-0V0 -7 v-=L-- Ale,7?d% r/ •PR'J . • •1-4 E t: Fiit�# i+iJ e x y )' •r.. AREA DESC' A N EXISTIN PROPOSED TOTAL SQ.FT. SQ. FT. SQ.FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS (DESCRIBE) DECK(❑COVERED OR Cl UNCOVERED?) GARAGE 0 CARPORT Q EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED ST TOTAL SF NUMBER OF FLOORS **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 UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(Commercial) COMPRESSORS FURNACES RANGES DUCTS. GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS iroiet) 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 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 ye-r1/4DATE �1 LS (Sign lure) (Title) RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent contractor ❑ Architect ❑ Other f ❑ NEW o ADDITION ❑ALTERATION ❑REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES ❑NO ZONING DESIGNATION CHANGE OF USE? ❑YES o NO NEW ADDRESS REQUIRED? ❑YES o NO UP/SEPA/SU? o YES ❑NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—January 1,2007 Page 2 of 4 k\Handouts\Permit Application