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12-101263 LR7 Or ECEIVE'D E R M I T Federal Wa� F CO ME PL DE E FP) COMMUNITY DEVELOPMENT sERticiamR 2 O zoA P PLICATION ----- 253-835-2607•F4\253-835.260 J,uv r Ter azr•,n Cm OF FEDEw4i. NAY COS SITE ADDRESS SUITE/UNIT# 3 al ZS 3 Z'"0 4J FL . .S. F , ) 'I �JA Qaao 1 is' Fi rz. PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# TYPE OF PERMIT CIBUILDING Li PLUMBING Q MECHANICAL El DEMOLITION [1 ENGINEERING FIRE PREVENTION NAME OF PROJECT (Tenant Name/Homeowner Last Name) A,rj oT i< PROJECT DESCRIPTION c'3 Ii e...-. i2i,i_ ciu' ©F `7174 SQ. F1, Opt 1/•alp i 57 1,—F—AF_1_ Detailed description of work to OF /A-4 rai-L i i r•tz. eA.,,L.L1:.-LG. _u5LAVE- Is I=.,(1.-S;`,"le, be included on this permit only S I..i%.Cite$ r ox. P-te.;.,) 1-01‘,I,,,..11.--; NAME ' ff PRIMARY PHONE PROPERTY OWNER 3z i z5 da-z...7)4 L-Le- 4iz.c zeci -11000 MAILING ADDRESS E-MAIL f;,IM 6EI..i._f=-.1+,0 0A'( 5 E CITY STATE ZIP Leff .4 ii t9A 90aoy NAME �Te-,...)A2T Fr Re (3--0; T r,.i-1 Z.Z.,e.- -qac 3‘;7-act 57 MAILLING ADDRESS ^ E-MAIL CONTRACTOR %c Lon i.41 La Ri) . 61-Fv.1,4ai Fit Q Li.1E,c AA CITX STATE ZIP FAX ,.514.C4a/4 isl,-E 1 t,.,rA 9 b cio WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# ..61.av,)14F-P e39ZPIQ i© / i9 / t3 -\i-i4:-)•473,4 -60-•RL NAME PHONE ,S 14*7.45, AS 414 r tzkz-Tz7 y'`L APPLICANT MAILING ADDRESS E-MAIL CITY I STATE I ZIP FAX PROJECT CONTACT NAME PHONE ' IAA �j' �'^ (The individual to receive and -.4t� ' ��4�1 Z536;7-29'57 respond to all correspondence MAILING ADDRESS E-MAIL concerning this application) 1935 1_)4,..i4S6. 5-reysaTFIREGL.Llta,WW1 CITY STATE ZIP FAX ....1414-40.44_i I--4 i A Cl c,19 c ALTERNATE CONTACT NAME: PHONE E-MAIL ..5-Tr-WAitrFi2M .. Li 4Y.LGfai1 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. ._ 'TIRE: / - DATE 3-- iCf`a_ %v." S7- ' £.)A-#2j January 1,2011 Page 1 of 3 k:\Handouts\Permit Application w • % k 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 ' :+t•F r its — s >_ ' # � -.; x � ,: - >�.„o i1 .< 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(mimeo/utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES ry ,� rE h'r1L 1Ni, 1,,ATION �14 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 U No '� 'RESiII• iN• L 1"1E f3R;ADDI t i F ,,:.. .., 4,.. AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Herne) ,ply } --- —. ..... COVERED ENTRY DECK sx', � g. aa b GARAGE H CAR I'OR'i LI OTHER(describe) '% `' ° ,, EXISTING PROPOSED TOTAL Area Totals K , **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ #OF BEDROOMS — C;U:� MERC;'IALs`— `+,EW/AI)DTTi4 v , AREA DESCRIPTION Area 1 Occupancy Group(s) Construction # of Additional Information in S.uare Feet Type Stories NEW BUILDING 1 ADDITION I ' =,,,,e,,,,, *a' lg ':'', - r . CoNINprE ciAi. F OnEIE;A T. 1iggICN N-ir. ", AREA DESCRIPTION Area Occupancy Group(s) Construction # of Additional Information in Square Feet Type Stories TOTAL BUILDING �4 ,r�, k r i L.;•...,� �. ter.« TENANT APIA ONLY '''i' I `;l l C, a Yl Lt.— -r.--x- , PROJECT AREA ONLY4. o � Bulletin#100—January 1,2011 Page 2 of 3 k:AHandouts\Permit Applicati