08-106071 a '
49
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:IBIC _ i c) 6 6 _ _I__
CITY OF 1P
Federal Wa 9 Z00% PER I T
COMMUNITY DEVELOPMENT SERVICES 0�c, SF MF CO ME EL PL DE EN 111)
333158m FEDERVENUEAL
WAY,OUTH WA
BOX 18 it
TIO N
FEDERA2 07.FAX
83210
253-835-2607•FAX 253-835-2609 �� --4--- _--_.__--
www.cityoffederalway.com t°1K P\r. S
117
The following is requi ormation-an plete application will not be accepted. Please print legibly(in ink)or type.
El PROPERTY INFORMATION
SITE ADDRESS 33507 9TH AVE S. SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 1321850000 LOT SIZE(s0
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) CAMPUS POINTE BLDG. A — CHRISTIAN FAMILY CARE
(Attach separate page for lengthy legal description)
II PROJECT INFORMATION
TYPE OF PERMIT BUILDING PLUMBING MECHANICAL
DEMOLITION ELECTRICAL ENGINEERING x FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
THE SCOPE OF THIS PROJECT IS TO ADD NOTIFICATION & INITIATING DEVICES FOR THE PURPOSE OF TENANT IMPROVEMENT.
PROJECT NAME(Name of Business or Owner Last Name) CAMPUS POINTE BLDG. A - CHRISTIAN FAMILY CARE
• PEOPLE INFORMATION
PROPERTY NAME
PRIMARY PHONE
OWNER
MAILING AUUNESS Ll IV,S IA I E,ZIP
E-MAIL AUUHESS
CONTRACTOR COMPANY NAME APPLILAN I NAME
UI-FILL PHONE
SMITH FIRE SYSTEMS MANAGEMENT,LLC. HOWARD WILLIAMSON (253) 248-2003
J MAILING AUUNESS U I Y,S I A I E,ZIP CELL PHONE
4 O / 1106 54TH AVE E. TACOMA, WA 98424 —
CNY OF FEULHAL WAY BUSINESS LICENSE NUMBER EXYIHAI ION OAI E FAX NUMBER
200610470900BL 12/31/08 (253) 926-0726
CON IRAC IOR'S HEGIS1 HA I ION NUMBER EXYIHAI ION DA IL E-MAIL AUUHESS
SMITHFS946LO 6/20/10 HWILLIAMSON@SMITHFIRE.COM
APPLICANTCOMPANY NAME APPLICANT NAME
OF
EICE VHUNE
SMITH FIRE SYSTEMS MANAGEMENT, LLC. HOWARD WILLIAMSON (253) 248-2003
MAILING AUUHESS CI I Y,S I A I E,LIV CELL PHONE
1106 54TH AVE. E. TACOMA, WA 98424
RELATIONSHIP IO VHOJELI
FAX NUMBER
Architect Tenant Agent xOther CONTRACTOR (253) 926-0726
PROJECT NAME PRIMARY PHONE
E-MAIL ADDRESS
CONTACT HOWARD WILLIAMSON (253) 248-2003 HWILLIAMSON@SMITHFIRE.CON
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING AUUNESS CI I Y,SIA I E,LIP
PHONE
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK$ 9986
SPRINKLERED BUILDING? YES NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? YES NO
WATER SERVICE PROVIDER LAKEHAVEN HIGHLINE TACOMA PRIVATE(WELL)
SEWER SERVICE PROVIDER LAKEHAVEN HIGHLINE PRIVATE(SEPTIC)
a � O I
PROJECT FLOOR AREAS
AREA DESCRIP1 ION EXIST INC, PROPOSED TO IAL
SQ.FT. SQ.FT. SQ.FT.
BASEMEN I
FIRS
3731
SECOND
I HIND l T13
ADDI I IONAL FLOORS(DESLE)
DECK( COVERED OR UNCOVERED?)
GARAGE CARPORT
NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF
**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) LAYS (Bathroom Sinks) URINALS
MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS
(7oileU
ELECTRIC WATER HEATERS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
' SIGNATURE
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 Feder. ay as to any claim ncluding costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may,- ade by any pers. ,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 a ?lacy of�the infor, • ion supplied to the city as a part of this application.
,•41
SIGNATURE: �G't/" r DATE 72
Property Owner•nd/or Authorized Agent
NEW ADDITION ALTERATION REPAIR TENANT IMPROVEMENT
BUILDING SHELL ONLY? YES NO BASIC PLA" r�. .. , v .__.. . x v __.
N? YES NO
ZONING DESIGNATION CHANGE OF USE? YES NO
NEW ADDRESS REQUIRED? YES NO - u
_ _ �. YES N .... ..n.>�.. ...,
UP/SEPA/SU? O
.W, �
PLATTED LOT? u YES .NO . . . . .w DEMO PERMIT REQUIRED , YES
NO
Bulletin#100-August 16,2007 Page 2 of 4 k\\Handouts\\Permit
Application