Loading...
12-101105 i ,,:. ! o ( . l0s Federal W coveD OPERMIT •MF CO ME PL DE EN (;ECJ E COMMUNITY DEVELOPMENT SERVICES 9 __ ORIGINAL 253-835 2607 FAX 253-835-2609 pC O V Mrd PPLICATI0N ip_w.rity.o ferieratwau.c2rre 0 CeDeOS ��M ? SITE ADDRESS CA 1 1'• OF� (COS* . SUITE/UNIT# 3.cgq q —1CTIi 4VIE. . 0, FEOeeAL WAy, 4)19. c I g e V 3 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# 4 $ X56 * .�� oz ' ;2 ( 0 (I _ 7 D az.__ TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING IV4IRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) --72)171.E fs6AM,512 ,i4s s PROJECT DESCRIPTION eEMDii- SPIT 6,414IcE O.ETEOT 1e 1=,0441 67 M ,9€6.4- Detailed description of work to Ee AVECT LAMP i4.))g11116 s 4GAAW-e1 F /3:04F� pezzie4A4 be included on this permit only rh p /AME PRIMARY PHONE PROPERTY OWNER `W 5 p '2 i0 Z53-'27-363s MAILING ADDRESS . E-MAIL 33330- gTAVE _ CITY STATE ZIP • reo ,RAL LoA1 a `isao3 NAME PHONE 51.44pC.E,Y 2d6-Z9/11O6 MAILING ADDRESS ,/� E-MAIL CONTRACTOR qS a0 '�f/)Ty,4t/E 54, iiQo CITY STATE ZIP FAX SEA 771.- 14J4 ygIDgab-zq1-1560 WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# 01,1,LL 41k4 98'1 'S4 / / NAME PHONE '50144. AS 61.4.3406•2 APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PROJECT CONTACT NAME PHONE (The individual to receive and -T-OM 1 M/3st 6 Fs ie, Z44- 316- &157 respond to all correspondence MAILING ADDRESS G -�L concerning this application) 3 3336 --87-d A JE vv, 5E(!utztT y -14roLma sk e lots.Qi CITY STATE ZIP FAX FEIi eAL )A1 L ) 98603 253 4s-zzei.7 ALTERNATE CONTACT NAME: PHONE E-MAIL DA'j'D eeMM EM 204-3.96- 427 5 _ PROJECT FINANCING NAME OWNER-FINANCED Required value of$5,000 or more (RCW 19.27.095) MAILING ADDRESS,CITY,STATE,ZIP PHONE 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 part of this application. SIGNATURE: A4J ( DATE 03--1' z©�L PRINT NAME: -I --n JOh I 14D PSIG I Bulletin#100-January 1,2011 Page 1 of 3 k:\Handouts\Permit Application r- - • i d 1t A " ,AI a C WORK (a copy of bid or estimate must be provided) 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. 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 Indicate how many of each type of fixture to be installed or relocated as part of this project. Do of include existing fixtures to remain. BATHTUBS(or Tub/Shower Combo) LAVS(Hand sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS S •W ERS VACUU I REAKERS DRINKING FOUNTAINS SI S( hen/Utility) WAT ' HEATERS(Electric) HOSE BIBBS SU PS W HING MACHINES M 7"�+ t +`s , . kv.. r�.,ct..: kk, .:u.�2.0.. < Y i y;• am:^- .�'' "z3 ...,s1'.�.x« ,• F a� a�s,�. ..xYr� � _�.ss,'.�`�';.. ,,;$: ,:�+,a'�.��,.�zi' CRITICAL AREAS ON PROPERTY? WATER PURVEYOR - 'YOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT S'- Ia Sq e Feet) 4-TING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes❑ No ❑Yes ❑ No u. a.,� ,;,ix�.,x.,s." -�...,>�'r^;` .��: ".,'a.• :.a„.. ...mac..,...<��.�.,. • AREA DESCRIPTION(in square feet) EXISTIN A PROPOSED TOTAL FOR OFFICE USE —_ -- — — FIRST FLOOR(or Mobile Home) -_ agifX- : ;;;1;,V far w : '., , • COVERED ENTRY /MI ,, GARAGE ❑ CARPORT 0 ----^ • Area Totals PMSTD70 PROPOSED TOTAL a ,ate a: a E : ESTIMATED SELLING PRICE$ #OF BEDROOMS a . ,llman GConstruction AREA DESCRIPTION Occupancy roups) #of A dditio'�nals�s In f..o,.rmakm ati•'o. nSt Stories • ADDITION AREA DESCRI' l ON Area Occupancy Group(s) Construction #of Additional Information in •uare Feet • •e Stories TENANT AREA ONLY M, Bulletin#100—January 1,2011 Page 2 of 3 k:\Handouts\Permit Application