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07-106410 i t k RECE1Ve • (y CITY PF o.....__.xras.:=�T 0 i - L O 7 4 t 1../ Federal Way Dov 2 9 2007 PERMIT SF MF CO ME EL PL DE E 6 COMMUNITY DEVELOPMENT SERVICES 33325 8''AVENUE SOUTH•PO BOX 9718 2F5E3D-8E3RA-L 526W0A7•Y.FAXWA 259380-86335-92789 OFF ENDGEDRCPLICATION TD / / MW_Wci.I iCtlenth Er;n BUILDI The following is required information-an incomplete application will not be accepted. Please print legibly(in ink)or type. • PROPERTY INFORMATION SITE ADDRESS o l N V I' --) fltic j-+, SUITE/UNIT# ASSESSOR'S TAX/PARCEL# (x. ?".6_,:k+ A - LOT SIZE(s Oy2/y /�y © 2 Q LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) r e 4ITri A icy Condos BIS( I�Qy -4:2) (Attach separate page for lengthy leg description ii PROJECT INFORMATION yJ TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING )(FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description of wok included on this permit onlu) Sm-v\ Fire SLiS.1-01s ivi I rOv� e (i Lot+ pipe &e- r©1 ec io() span L ler s S i .-Fo .rateC�i it1 r(or o-P e Soca ctiv l. PROJECT NAME(Name of Business or Owner Last Name) c e_Q I (k)o, l n iS MI PEOPLE INFORMATION PROPERTY NAME ....___, , , PRIMARY PHONE OWNER �c�u�:4-k1 Ft) r�, 1--tomes L1-6 ( - ) c.,,,-;$a--,--/3=3i MAILING DRESS CITY.STATE,ZIP E-MAIL ADDRESS G153610 o x ci;o SiAtelnerf :61.1 y$Ch CONTRACTOR COMPANY NAME / ' ` APPLICANT� NAME OFFICE PHONE iLING ADDRESS, . (Mepp lt S LI,CITY,ST1TE. 'IF- I m� -72/ CEL ONE -o(pr717 CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER /C, 27—do0055c-00 -, L /2/3/. 7 ) 9a&-233-0 Copy of card required CONTRA/CyTTOO/RSRRr'EGISTRA ON NUMBER /j`,�/T EXPIRATION TE �/(� E-MAIL ADDRESS `n'��-�/)/�qJ�/ tr,�,,1 j 7 / .�}� with each application ` I" ./// hi-. /3( �/ I //1 2/M V Js en be G•IV•sl•t`/,/ I•re't�or APPLICANT COMPANY .NAME (� �? APPLICANT NAME/ / ( OFFICE PHONE PLILIILIINNG AADDRES SI+t`l 1 t lad CITY,STAATMv' V i�+(-�Q]& a� ( 3 )a�$ -G71��� 1 'V(Y Ave_e_ E Taaio nZa &i / / gqq CELL PHONE RELATIONSHIP TO PROJECT ill( f` r �C-' FAX NUMBER 0 Architect ❑ Tenant 0 Agent Other /17 �OGf L° (�� )��b -a�D PROJECT NAME �� n (ten PRIMARY PHONE/ p E-MAIL- AD RESS CONTACT �U�JiI / IUC�JL�.� e ( Si )p9 - l gOO I,-i-�sSen Q rcm • -�-' LENDER NAME J Per RCW 19.27.095: V Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - ■ DETAILED BUILDING INFORMATION EXISTING USE (_orgy O 5 PROPOSED USE C O r' in EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $e;201//3 '— SPRINKLERED BUILDING? OYES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? •DYES ❑ NO WATER SERVICE PROVIDER ,I LAKEHAVEN 0 HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) • ni PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ. FT. SQ.FT. SQ.FT. BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(❑COVERED OR ❑UNCOVERED?) GARAGE ❑ CARPORT 0 NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL ERl4TINO SF TOTAL PROPOSED SF TOTAL SF "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 BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(commerdal) COMPRESSORS FURNACES RANGES DU(,IS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower combo) LAVS(Bathroom smksl URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS rrouet 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. �/ NAME/TITLE .I i DATE /// /(/�t / (Signat re) (title) RELATIONSHIP TO PROJECT ❑ Owner 0 Agent ❑ Contractor o Architect #Other e/ryp/000e FFR diiiiif.-i-i-410,` ,�,..,.. o NEW o ADDITION a ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES a NO BASIC PLAN? a YES a NO ZONING DESIGNATION CHANGE OF USE? ❑YES a NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO PLATTED LOT? o YES o NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—January 1,2007 Page 2 of 4 kJ-Iandouts\Permit Application