02-103934 4„.J) A
•
`T'°' G -p�� CONS I RUC I ION PERMIT APPLICATION
VV FT), ' EIVE[} APPLICATION NUMBER: ' �- L Q 3 -�
APPLICATION NUMBER: - -
SEP 1 2 2002 APPLICATION NUMBER: _ _ -
**The following is required information-Please print(in ink)or type**
.
Please note: Electrical, FircgioFn7R;
les and Engineering permits may require a separate application.
••••• = 10 PROPERTY INFORMATION
SITE ADDRESS: oki ASSESSOR'S TAX/PARCEL #:
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
_ �.....�_ ,..• _ . ;.11 PROJECT INFORMATION'`.
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description): Cr TR\' I KE__ a_tkag 2�2 BATI-t c 4�
C SICeNCE \1TN kt-rACI.IED Qtt\RAC-F .
PROJECT NAME: 225- [3ASIC..tt' S I E j I)t /619
• FA PEOPLE INFORMATION • . i.
•T
PROPERTY OWNER: NAME: DAYTIME PHONE:
NEA DE2. uoME4 114G. (Z06 )248 -247 I
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
&5l�So�TNc 9 vc "jr»[W�L 9aI
CONTRACTOR: NAME: `,V`C- S DAYTIME PHONE:
MAILiNGbCA (STREETTE, l 1c_. ( )248 -24171
EVENING PHONE:
(0b10 BooT L 5Lvrz . `tv/twu &,W . %8I8? (z' )248 -2.417/
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
1 `L - g9-LI o76,24-oo- �L_ (2( )Via - 4 2.6ci_
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) SCI-INE e2.145 eta _ _ _ a3 /01 / 03
APPLICANT: NAME: DAYTIME PHONE:
R-C &NFA. (2o )24€ -24/1
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
X510 Sou--W CEn3 Te 2. BLvr. kw ii.p, P%0 581&Q� (2 .10 )24'2 -42-09
RELATIONSHIP TO PROJECT: FAX NUMBER:
❑ ARCHITECT ❑ TENANT OTHER(DESCRIBE):RaN1. AN 4 1 , ( )242 - 4209
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER Xi APPLICANT. ❑ CONTRACTOR
A DETAILED BUILDING INFORMATION ' •
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: ,.F. 2. (NEV )V. PROPOSED VALUATION FOR IMPROVEMENTS: $ J SO)WO
SPRINKLERED BUILDING? ❑ YES I3,NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ' NO
WATER SERVICE PROVIDER: LAKEHAVEN ❑ HIGHLINE ❑ TACOMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER: )LAKEHAVEN HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTIOtLY** •
NUMBER OF BEDROOMS: 3 ESTIMATED SELLING PRICE: $ 2 2O, ODy
1.1 PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL
BASEMENT /
FIRST
SECOND '�6� � I co--7 91
THIRD
FOURTH / �,
OTHER FLOORS(DESCRIBE) 7------ __-
DECKGARAGE
\ /
HOW MANY FLOORS? (piJGG
44 P 25 ,
TOTAL: 240 iS Pi *.l07. O fi
. ... ..,...•a•?t'ri.;...:—. ..-e.4.1 s ;.t r.Gs:+aia. FiATVRE.S4:4.;f+* 4.4.!roia�ri+�i!iu&t,•t4, 4..6. :4.:.4.0:mr gti.»:..
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) 1 REFRIG.SYSTEM(S)
BBQ(S) y- FAN(S) I HOOD(S) WOODSTOVE(S)
BOILER(S) 1 FIREPLACE INSERT(S) / RANGE(S) MISC.( )
COMPRESSOR(S) I FURNACE(S)
3 DUCT(S) 3 GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ‘111"g GAS
PLUMBING
Z BATHTUB(S) , II y LAVATORY(S) • URINAL(S) I WATER HEATER(S)
' I DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC X GAS
DRINKING FOUNTAIN(S) SHOWER(S) 1 WASH MACHINE OUTLET
GAS PIPE OUTLET(S) '2.r SINK(S) 3 WATER CLOSET(S) MISC.( )
INTERCEPTOR(S) SUMP(S)
7:1 = ' -''7.4'DISCLAIMER/SIGNATURE BLOCK . .
I certify under penalty of perjury that the information furnished by meis 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 daim(including costs,expenses,and attorneys'fees incurred in the
investigation and defense of such claim),which may be made by any person,induding 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:• —��/�. [SATE: �/
❑ PROPERTY OWNER 0 APPLICANT P CONTRACTOR
FOR OFFICEIJSE-ONLYilt
'$vr�".x„ ,�,,��=� .xw.ea�xex � �:. c •:. � �. .: �,h� a rr r; xt e�a 'x�.�� ,�.
_TNEW,„ —❑ADDITION( " ®,ALTERATION#, *U:i:REPAIR . :D TENANT IMPROV M_ENT�'
10ENSUSICODE.. '' 3 i SLOT IZE: _`'y # :- :`i 'rt. ;,----:.
,*-614 LG, ' SIGNATION -m0 ILDIN SHELL ONLY??�"L] YES ;0 I!NO„� ;.
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P' ANDESirGN IOt �n !AN? 'id_ •--Es- ;1 0
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0_N 4 TOWNSHIP g RANGE j arttp REQUIRED :k;r `(ES EJ wow
XPi `C rU L1DT? •[J 1('FS' NO ;"; , TkilGE OF' SE?t' xr' ❑YES O IM .
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COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTTi•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.dtyofedera Iway.00m