Loading...
11-100114 • CIn or A . © O 1 Zk_ Federal Way • PERMIT ' M „� , �. E FP COMMUMTYDEVELOPMENT SERVICES APPLICATION 253-835-2607•FAX 253-835-2609 JAN 11 21:.1 www.dtuoffederalwau.com 1$ g CITY OF FEDERAL WAY SITE ADDRESS ,s2,-,24..) s`` D SUITE/UNIT if mow 32+J n )�v� =a IN ii 0 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ (.000, . ,4- a _ • 0 O .� o TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING NE4 FIRE PREVENTION NAME OF PROJECT �ry�]� /� 1/p �jy� �� /� (Tenant Name/Homeowner Last Name) -Ni c , ; al. Atm,.,,�I S` KA i)OIv a/14 I (-1 )(j NUN� v E'7�%�ryt Js ` W PROJECT DESCRIPTION r.a.i ALA d2-1,-+ Th)A#1.1i t.,pR-.:1 r. ;y.12.- ?1.Aa Detailed description of work to be included on this permit only NAME PRIMARY PHONE PROPERTY OWNER r:tr��;_ MAILING ADDRESS E-MAIL 32 tJn AV2 S CITY STATE ZIP NAME PHONE `I` ', sgwILry, LL.c, z5 ztiy IyHS OMAILING ADDRESS E-MAIL C NTRACTOR ,-..."::...(P°"7 Vol Il�TN N:�, 74 +Y5d6Li rtLF Q 1-20/43)1:9,c AWS-/ CITY STATE ZIP FAX A") (r$ 81117 EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# WA STATE CONTRACTOR'S LICENSE# tap�K=L F 5`13i 1 L G / / NAME PHONE 5> - At. c z,nnsZAc.-rcNC APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PROJECT CONTACT NAME PHONE (The individual to receive and 1 r ' )''�'"\ p= -I /'i -f respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) 1-,6°-? `t1`f Ill A.'L. 3AcRVIc2i-I21" 11 Rrir rl5cZ ., CITY STATE ZIP FAX A21,.INt.-1 +\., :r,`2 3 36c> (es'j ey3.7 ALTERNATE CONTACT NAME: PHONE E-MAIL PROJECT FINANCING NAME ---— Required value of$5,000 or more El OWNER-FINANCED (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 arty 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. iNATURE: ! �-�' i / DATE IT NAME: J i^i- 2oSSA Zf� 100—April 14,2010 Page 1 of 3 k:AHandouts\Permit Application • 0 MECHANICAL FIXTURES VALUE OF MECHANICAL 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 PLUMBING FIXTURES 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 SINKSKitchen/utility) WATER HEATERS(Electric( HOSE BIBBS • SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR (SE PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes ❑ No ❑Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals / **NEW HOMES ONLY** ESTIMATED SELLING CE$ # OF BEDROOMS COMMERCIAL-NEW/ADDITION AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information in Square Feet Type Stories NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information in Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY , PROJECT AREA ONLY ) Bulletin#100—April 14,2010 Page 2 of 3 k:\Handouts\Permit Applicatio