08-101323r e . -
CITY OF 4:` • F _ / o ( 3j- 3
Federal Way- --° PERMIT
COMMUNITYDEVELOPMENT SERVICES SF MF CO ME EL PL DE EN FP
3332F8TH RALAVENUE WASOUTH•63 BOX 9718 PPLI CATI O N
FEDERAL WAY,FAX
98063-260 MAR 19 Z A TD 7 (_„.,m,2 253-835-2607•FAX 253-835-2609
11111 v eityoffederalway.corn
The followi�^isfgt fre�1> �pitaiv pomplete application will not be accepted. Please print legibly(in ink)or type.
C.11 • PROPERTY INFORMATION
SITE ADDRESS_4327 SW 335th Street SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 1421039053 LOT SIZE(sf) 26,872
LEGAL DESCRIPTION _POR OF GL 2 BEG AT PT N 00-37-31 W 255.2 FT W & S 89-12-18 W 173.4 FT
FRM SE COR SD GL 2 TH CONTG S 89-12-18 W 173.4 FT TH N 00-37-31 W 8 FT TH S 89-12-18 W
35 FT TH S 00-37-31 E 135.6 FT TH N 89-12-18 E 208.4 FT TH N 00-37-31 W 127.6 FT TO POB (separate page for lengthy legal description)
IN PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING X FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
Install new residential sprinkler system in new house.
PROJECT NAME Par residence
• PEOPLE INFORa,,,MATION
PROPERTY NAME '/ y�f� P11MARY PHONE
OWNER a!7/r b(''�// ��Nv"� /� (4j35 )V171 -/17X)
MAILINGIADDRESS / YY,,STATE,ZIP // ax
E-MAIL ADDRESS
CONTRACTOR COMPANY ic)ioQt-i APPLICANT OFFICE PHONE
r1Q am.ii 2,s 0,3c . '3 Sc -P5eiZc ,,43-'e74.., - 1`'t
MAILING ADDRE
�q CITY,STATE, CELL
} CELL PHONE
CITYrxt-r
nas
FEDERAL WAY BUSINESSLICENSE NUMBER N v,`EXFPIRATION DATE FAX NUMBER
2 c' as" /ODS 31 `eez- i, 0* (2 63 )8 -1,z7)3
COPY o[card requimd CONTRACTOR'S REGISTRATION NUMBER EXPI TION DATE E-MAIL ADDRESS
with each appticutiou RESIDFS948NN 12/31/08
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Fire Sprinklers Inc. Mike ( 253 ) 826- 0099
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
1014 North St.#200 Sumner,WA.98390 ( )
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect 0 Tenant 0 Agent X Other ( ) -
PROJECT NAME PRIMARY PHONE . E-MAIL ADDRESS
CONTACT 121/r/ /xe /-7,/,< �� � ( Y) - ✓ / 9 mike(a firesprinklersinc.com
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY,STATE,ZIP PHONE
( )
■ DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE �� //
EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ tY c44'
SPRINKLERED BUILDING? X YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? X YES 0 NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIGHLINE n TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ. FT. SQ. FT. SQ. FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(❑ COVERED OR ❑ UNCOVERED?)
GARAGEr ❑ CARPORT ❑
N V MBER 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 offixture 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(Toilet)
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.
4111.
NAME/TITLE � leirr DATE WI 47 t23
(ignature) (Title)
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent o Contractor ❑ Architect o Other
FOR OFFICE USE ONLY
❑ NEW ❑ADDITION ❑ALTERATION ❑ REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? ❑YES ❑NO BASIC PLAN? ❑YES ❑NO
ZONING DESIGNATION CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? ❑YES ❑ NO UP/SEPA/SU? ❑YES ❑NO
PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? ❑YES ❑NO
Bulletin#100—January 1,2007 Page 2 of 4 k\Handouts\Permit Application