Loading...
07-106407 ill 1 Q \ 1 ' 7 CITY of Federal Way ; BGG _9 ra) 1,+ RMIT COMMUNITY DEVELOPMENT SERVICES P 1- SF MF CO ME EL PL DE ENO 33325 D AVENUE LWAY,WA 0 BOX9718 *3%1 lv 3 LI C ATI O N FEDERAL WAY,FAX 98063-9718 •a. ID / / 253-835-2607•FAX 253-835-2609 u,_w.d u,ikgk'nOwa.com 'ci O�O\\AC> The following is required{rlfdehiation-an incomplete application will not be accepted. Please print legibly(in ink)or type. 1 }�/� • PROPERTY` INFORMATION SITE ADDRESS L)1 1 V a (U �� SUITE/UNIT# ASSESSOR'S TAX/PARCEL# r- . }U( - r _4- LOT SIZE(s ) LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) ` P.cti,r& Way Condos 8/Act( n =,Q /Attachseparate pagef lengthy leg descriptionalPROJECT INFORMATION TYPE OF PERMIT ❑BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING X FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of wok included on this permit onitO m;-1rh hre St�S-WIS iui 1 7('o'�i L�. (I)wt--t- pipe_ direprof-echo() $ rinkle st4Sitin -fp C'4- e, in c for p-v----me._ UCkl(C tl• PROJECT NAME(Name of Business or Owner Last Name) ("e ideXal a Tc"-dkS P � • PEOPLE INFORMATION G� OWNER TYPROPER NAME © _►_ t..A 1,lb-}E f MAILC'^ /� �^ E-MAIL ADDRESS � � CONTRACTOR COMPANY NAME APPLICANT NAME OFFICE PHONE 5�mf 5m --,v\ ti&ferns Sh,leLj(-;laSSmatri (as3) a�8 -0(0'77 1 LlJ�Y AD5 1 171 rlwC�` y cot -,a ,W8 P/ (IP Ax Num) COY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUM/BER /C—87-100005c 00 -&. /2/3/107 c ) 9w--,23So Copy of card required CONTRACTOR'S R/EGISTRA ON NUMBER EXPIRATION TE E-MAIL ADDRESS with each application yl9/ / IS - /o OT ) ` / J /{ i�/Al 7�1 / /IIYA //1 / U 115 r APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE mh ADDRESVire re Rk1R c S Ale_ GtoLssstnan (aMc3 )a )A2 -30‘fl -qiLs CELL PHONE Q(ry S Ave_ E RELATIONSHIP(YPROJECT 7/�/ / / /x c�ove- C FAX NUMBER 0 Architect 0 Tenant 0 Agent VOther e/Yy1 for' V53 ) ,9b - 30 PROJECT PRIMARY PHONE AIL ADDRESS JCONTACT j/Jn /seL lFus3) 9a - inpo Visenx _TNi)i NAME 1r`Cm LENDER NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS COY.STATE,ZIP PHONE ( ) • DETAILED BUILDING INFORMATION - EXISTING USE C-0(\d SCS PROPOSED USE Condos EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ &'11 `'r) / — SPRINKLERED BUILDING? RYES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED?. YES ❑ NO WATER SERVICE PROVIDER XLAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) 1 SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) • PROJECT FLOOR AREAS ��. AREA DESCRIPTION EXISTING PROPOSED TOTAL Sg. FT. Sg.FT. Sg. FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(❑COVERED OR 0 UNCOVERED?) GARAGE ❑ CARPORT 0 NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTEXISTING TOTAL PROPOSED SF TOTALSF **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 $ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBgS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(commercial) COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETb REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSE lb(rateO ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS SIGNATURE 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 of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a part of this application. j NAME/TITLE � _ .,I '� DATE ///2/6 r (Signa re) (Title) RELATIONSHIP TO PROJECT 0 Owner 0 Agent ❑ Contractor 0 Architect Other `0f2/2/'0//6 ;0171)040.i41#04:41.„ =, o NEW o ADDITION o ALTERATION o REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? o YES ❑NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? o YES ❑NO UP/SEPA/SU? o YES o NO PLATTED LOT? o YES a NO DEMO PERMIT REQUIRED? a YES a NO Bulletin#100—January 1,2007 Page 2 of 4 k\Handouts\Permit Application