17-104376 RECEIVED
+
CITY OF h....., ;EP 1 1
PERMIT APPLICATION
Federal Way 2017
ERMIT CENTER+33325 8thAvenue South +Federal Way,WA 98003-6325
FL...ti�,.2 3-835-2607 + FAX 253-835-2609 +permitcentern)cityoffederalway.coin
COMMUNITCITYOF7 DEVEDERAELOPMENT
PERMIT NUMBER i , _ f 0 Li 3 r _ T UI
ARGET DATE 1 L
SITE ADDRESS SUITE/UNIT#
340'S (011 S c' ' - &V Al Wt. a goo
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ c:,&s"cxl, 13 2 / 0 3 _ 1 / 03
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION 0 ENGINEERING AFIRE PREVENTION
NAME OF PROJECT 4.04
%ur`J AJ%i,t 1¢A) LJ'w(g &J£I TE,e S Pit
—
PROJECT DESCRIPTION /NT>�
S 'I iSI O CA-E$ rb PICOVVrdit, Fntt AMA"!
Detailed description of work to
be included on this permit only
NAME PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS E-MAIL
CITY STATE ZIP
NAME A
ofrfts r/, O)' co PHLo 9 833$ 7
/� /'
LNG ADDRESS ,(,� N E-MAIL
CONTRACTOR 3 3520 (f % pc!t Ef �' Dui
CITY STATE ZIP FAX
Au60RN h!R' cr So01
Wc.TATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
ilvrhre9v4bk.. 3 , 1S" iZb1e
NAME�r 64 � � PRIMARY PHONE
At 64 42sco4 g aZ 3 7
APPLICANT- MAILING ADDRESS g_
13(0 of /$8 TO 5t 6 , 6/41.60 A L.wrs.Ca+r+
CI'75 STATE
'TIM lop IVB1�' ZIg8a,P FAX
NAME PRIMARY PHONE
PROJECT CONTACT A 164, 4co l.12c'GM€ 333 7
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence
concerning this application) CITY STATE ZIP FAX
NAME
PROJECT FINANCING 0 OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP - PHONE
(RCW 19.27.095)
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 of this application.
SIGNATURE;/`G DATE // S ,oT J 7
PRINT NAME: /7/6
K. I k 0
Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how of
many- each type offixture to be installed or relocated as part of this project.Do not Lnctude existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial)
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
VC l.LV1Y1bI1YV YYVl'CL1
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(Hand 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(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
❑Yes ❑ No ❑Yes ❑ No
I RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
,0�
FIRST FLOOR(or Mobile Home)
aa,
rias
�."i' Y n..-rx�-' iA i" °� . ' S�'3�' �..�i .,;rt I, w.Y.N"t •.n` ..'!m5 ..___._... _.___—.
COVERED ENTRY
-4.41a$37-1- :041;1'47,01 .;4.
I!= ._.___._._....._.__.................._._ _._....._._.._....._.._...__...._-__..._....
GARAGE 0 CARPORT 0 •
i !!"44444•4`;44k•4'. air
EXISTING PROPOSED TOTAL
Area Totals
ESTIMATED SELLING PRICE$ I #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION
Area in Occupancy Group(s) Construction I # of I Additional Information
Square FeetI T; St .e.
��-. 5F y,, r � s=(,,'�s,a � *A-•';`5�'�s z k�a.,nyt S,n TI, ''�`m3%- a :3 u ;� ' +k' S, iO
P &M LM
ADDITION I.
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
Area in Construction #of Additional Information
AREA DESCRIPTION S uare Feet Occupancy Group(s) • a Stories
•rr (0'„ • i;• "".o. ,.m txr *s
V.
� 7w -,�,=d+, ._,art "r_ _ ✓r4 .',as `"
TENANT AREA ONLY
"
43
xar t,w 441
• C' ''4741:4`: Y. , 4-44-44,4444-`•
vs y# � ROJ `L` ,+;�„ .}�4'.,O a 4 z #,.." -4,444,V•4:4-:
x`", ;` m 0,.,+,#< sr�' • 4 -414'41-:1441 o
•
Bulletin#100—January 29,2016 • Page 2 of 2 k:\Handouts\Permit Application