04-102885 FF-5
(� APPLICATION NUMBER: -CONSTRUCTION PERMIT APPLICATIOyN
CITY OF l
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Y
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15
Federal Way APPLICATION NUMBER: -
JUL 2 1 'NM
��p� APPLICATION NUMBER: -
**The fol etCiil�d`ililtirmation—Please print(in ink)or type**
{-�"�11' �NG DEPS
Please note: Electrical,Fire P�Y�,T[�bh Systems and Engineering permits may require a separate application.
• PROPERTYINFORMATION
SITE ADDRESS: "; ` . nv ASSESSORINFOMAT'S TAX/PARCEL#:
LEGAL DESCRIPTIOM1 )PR (A7y ttriM I ON IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING o MECHANICAL ❑ DEMOLITION
o ELECTRICAL o ENGINEERING 4 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description):
Add 20 sprinkler heads
PROJECT NAME: Kay Jewelers
• PROJECT INFORMATION
PROPERTY OWNER: NAME: DAYTIME PHONE:
Steadfast Companies ( 253) 839 - 6156
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
1928 S. Seatac Mall Federal Way, WA 98003
CONTRACTOR: NAME: DAYTIME PHONE:
Crown Fire Protection, Inc. ( 425) 481 - 7669
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
P.O. Box 12113 Mill Creek, WA 98082 ( )
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: 9� FAX NUMBER:
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(copy of card required) C $ W F P 0 4 4 L L /
NAME: DAYTIME PHONE:
APPLICANT: ( )
SAME AS CONTRACTOR
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
( )
RELATIONSHIP TO PROJECT: FAX NUMBER:
0 ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( 425) 481 - 8695
E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER o APPLICANT CONTRACTOR
• PROJECT INFORMATION
EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
ft
PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ 2 g WO. l_ YUVP.
SPRINKLERED BUILDING? ,o,YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: ❑ YES ❑ NO
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PROJECT FLOOR AREAS
FLOOR EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS(DESCRIBE)
DECK
GARAGE
HOW MANY FLOORS?
TOTAL:
■ FIXTURES
Indicate number of each type of fixture
MECHANICAL
AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S)
BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( )
COMPRESSOR(S) FURNACE(S)
DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: o ELECTRIC o GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC o GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) SUMP(S)
■ DISCLAIMER/SIGNATURE BLOCK
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 applicatiioon./21n-
,_`
NAME/TITLE: IriAA-2/PC��l , I /� IC��1T DATE: 7/2clog
o PROPERTY OWNER o APPLICANT ❑ CONTRACTOR
FOR OFFICE USE ONLY:
❑ NEW 0 ADDITION o ALTERATION o REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? 0 YES 0 NO
COMP PLAN DESIGNATION BASIC PLAN? 0 YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? 0 YES ❑ NO
PLATTED LOT? 0 YES o NO CHANGE OF USE? ❑ YES 0 NO
COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129
www.atvoffederalway.com