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13-102217 REE ED I <<;AY 20 2013 PERM _ ICATION Federal way . 0 0 O CITY OF FEDERAL WAY CJI - 3d eaa j CDS PERMIT NUMBER / 3 - / 6) 2 ? F-73TARGET DATE SITE ADDRESS �L / SUITE/UNIT# 33 11 4 q* A ve S Feeleral w PROJECT VALUATION ZONING ASSE`SSOR'S TAX/PARCEL# $ I/ g 70 q2 C s' 0 1 - o o G o TYPE OF PERMIT ❑BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING li FIRE PREVENTION NAME OF PROJECT 60)(ff.m1f ROAN, 7 T. PROJECT DESCRIPTION A161 /_/ f5" mete f heals 149(I / �o V4 4t1��o/afi Detailed description o work to d�Gs be included on this permit only NAME , PHONE PROPERTY OWNER Gold , shs,e ProperfieS 41.G -CO 0104 _ MAILING ADDRESS EMAIL CITY STATE ZIP NAME ..... f eiegriV' :re L L G PHO 20-gc7 2 a i MAILING ADDRESS p E-MAIL CONTRACTOR 11 D 21 Grf�� oiwer •�t X.P W ei# 1' 4 A®vile addf ir'e/ C. o, CITY (I,g i !}ur!►vr STATE ZIP FAX F 25'3 -07- Z312- WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 9 _E.MERAFLitg0MK 7%tq / 1Y 20.06-1030470-©o-IL NAME K4O.€f ,1 i 11S#rvit11 PRIMARYPHONE 2V-157-20,4 a 7-2 0,G -- APPLICANT MAILING ADDRESS n E-MAIL 11021 (dopier RI K*AN, ,/ Ka�#ero»ti Q e.«tralIii elUC,,4c CITY STATE 4; rif? _._b. Wif ZIP FAX 1 32 q 2. .C5-07-2y1 . .. .__ _ _.NAME •/� PRIMARY PHONE • PROJECT CONTACT A»q%a Vogl pet z j s-97c1- 20.re (The individual to receive and MAILING ADDRESS Q � E-MAILrespond to all correspondence J 1 OZ) CAl.AHlee, !(t .i.. Ahq,e VIP eMerulclhrelle,49:41 concerning this application) CITY STATE ZIP FAX 6if Park: WA- 9.0.Z1 7S'3-eft-2312 PROJECT FINANCING NAME X OWNER-FINANCED Required value of$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 partrof this application. application. SIGNATURE: l���I�N' ' 'k `(46( ®��C�H. DATE c/2°/q PRINT NAME: kawtetoYt 14i 11, fee 41 Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application • P VALUE OF MECHANICAL WORK MECHANICAL PERM' ` ' Indicate how many of each type of fixtureto be installed or relocated as part of this project. Do not include 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 VALUE OF PLUMBING WORK 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 0 No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in 3square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE Mg ... ..s A a;' „"f„ ' , s,.. ,,kl,£ ,'a,asH'„ .. .r .k • FIRST FLOOR(or Mobile Home) #" Q a Vic„ COVERED ENTRY ...:: 90#0640010.t ��,� .„ � ..?1‘.40-Alf: .i0144 GARAGE 0 CARPORT ❑ =STIRS PROPOSED TOTAL Area Totals ESTIMATED SELLING PRICE$ ( #OF BEDROOMS' COMMERCIAL-NEW/ADDITION AREA DESCRIPTIONPPM" Occupancy Group(s) Construction #of Additional Information e Stories ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area #of AREA DESCRIPTION in uare Feet Occupancy Groups) Construction Stories Additional Information •;•:".:44 k�= y \ .__'754 £ hMilatriliggirAliatial AVM' cb TENANT AREA ONLY Bulletin#100—January 1,2013 Page 2 of 3 k:\Handouts\Permit Application