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05-106343 Federal 1ilj/13 200 a - __i__ �MMU149‘.1 PERMIT — M7YDEVELOPMENTS '.i+ y'pKptLSF MF' CO ME EL PL DE E FP 33325Q�AVEIWE� s,. DEPT. APPLICAT AT106 • 22X29 • 1muw.dt yol redetal wa y.com The ollowi • is re• fired in ornurtion-an Inco •tete a.•lication will not be acce r ted. Please •rint le.ibl in i or • IllPROPERTY INFORMATION ' SITE ADDRESS 32 2.-7.5 3 2 �t' A✓L' S SUITE/UNIT# ASSESSOR'S TAX/PARCEL# - — --- LOT SIZE(sf) 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 XFIRE PREVENTION SYSTEM PROJECT DESCRIPTION �E�o�� ! i O �PTIONdetailed description of work included on this rmit ont (Provide /3u(L . 1,c! 1 ( D L D CAS os.J'C f?.eoIDtle Yit1/-49 �t1Ac1[. jz'r-T PROJECT NAME(Name of Business or Owner Last Name) E)/E Je j 4 A E U 56.----/C_ W "1 D(. L k6(}1.\ • N PEOPLE INFORMATION PROPERTY NAME ' OWNER PRIMARY PHONE • t^J�G D RES /-/A eV s e,e — D E t3�.,a la t�ni5 tit./ 1 (z.53) 924-- S!0 5 MAILING CITY,STATE,ZIP 33 G./...3 v✓a . �.1►Al 5 �w (_ („P )4 'Soo 3 CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE ?7Ac4(oi Fi,2E �cj r/$'( (253)284 -3429 MAILING ADDRESS CITY,STATE,ZIP CELL PHONE Z?0"7 -i o-r ` A•1 t E TAG o ,. 4 5,,,4z-4 ezi3)4 o S 7 94 g CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE -. FAX NUMBER -s / / (253) 921. - ZL4o L CONTRACTORS REGISTRATION NUMBER(copy of card required with each application( EXPIRATION DATE / / APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE PAT,e tcN-1 FO C ( ) _ MAILING ADDRESS CITY,STATE,ZIP CELL PHONE RELATIONSHIP TO PROJECT ( ) FAX NUMBER ❑Architect o Tenant ❑Agent ta Other(Describe) Com 7;t0.4 G Yo , ( ) - CONTACTNA PRIMARY PHONE E- LADD I ITs.D /fcf/ I (-253)Zts4 -342 9 I gear- P474407 LENDER NAME MAILING ADDRESS CITY,STATE,ZIP ■ DETAILED BUILDING INFORMATION EXISTING USE D r r'l e e" - DA-TA A CT/2_ PROPOSED USE O r r-% G L' .- 1 A-rA C Ti' EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 4 4 C 14 64 • ou SPRINK ,ERED BUILDING? ciLYES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED /REQUIRED? etaFS ❑ NO WATER SERVICE PROVIDER OkAKEHAVEN a HIGHLINE O TACOMA p PRIVATE(WELL) SEWER SERVICE PROVIDER a LAKEHAVEN a HIGHLINE . 0 PRIVATE(SEPTIC) • PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST 9l� c • \Zj$ �12,� 4� SECOND `T-7/0 -7)J : - 32,n5 4 9 21 sas4 THIRD FOURTH ADDITIONAL FLOORS(DESCRIBE) DECK(COVERED?) GARAGE 0 CARPORT 0 R7QSnMO PROPOSED x, af�,t -.�v- J.s :,A..L': = a„s;. ilL ,}.,,,,,,,.�,!'d i,d.AL NUMBER OF FLOORS �: H'4'1` **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 $ • AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS BBQS FANS HOODS(commerci.Q WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC(Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS PLUMBING BATHTUBS(or Tub/Shower Combo) SHOWERS WATER CLOSETS(rows MISC(Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS(Bathroom Sink.) VACUUM BREAKERS ELECTRIC WATER HEATERS DISCLAIMER/SIGNATURE BLOCK 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 oft city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE DATE /0/_.,740 (Signature) (Title) RELATIONSHIP TO PROJECT 0 Owner 0 Agent Co tractor 0 Architect 0 Other l ,!)4044te) ( tt0 , ' 4c014.: 0- 1 J4 L�s�? )(c 3�6,via .=„1-5•:-A, i(© :3'A prof lt-) a/ va 4111re l.�Q��' ` C°'3 *(0) )6J `( t irl.kr �acjtpi;��S®13 • Bulletin#100—January 7,2005 Page 2 of 4 k\HandoutssPermit Application