Loading...
06-105316cory 8,; A RECEIVE4$ Federal Way PERMIT COMMUNITY DEVELOPMENT SERVICES 1O "" 33325 87H AVENUE SOUTH • PO BOX 9718 P L I C A T I O N FEDERAL WAY, WA 98063-y�,t� 253-835-2607• FAX 253-83ay O F F E D E RA ����nu.cttuoffederahum,.corn BUILDING DEPT. The following is C SF MF CO ME EL PL DE ENO D will not be accepted. Please SITE ADDRESS ,U-/00 Pwat, 11,VyAyV 5yu+tl �rr�eru l UfQU ,, Li,IA- ASSESSOR'S TAX/PARCEL # 2 0 — / r') - -,!( - 9 l 7 LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (Attach separate page for lengthy legal ol--rpd.n) PROJECT INFORMATION SUITE/UNIT # LOT SIZE (sj) or TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING VIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit only) PROJECT NAME (Name of Business or Owner Last Nam el WA 6-1) lel->LR IS 15 ,. LA # %ki 4- PEOPLE•• • PROPERTY OWNER CONTRACTOR APPLICANT CONTACT LENDER NAME PRIMARY PHONE W,9, Kerr° ,VS ( - MAILING ADDRESS CITY, STATE, ZIP MPA AME I -APPLICANT NAME OFFICE PHONE MAILIN DRESS 7oS Co���aafc Stre�-j- CITY, STATE, ZIP Kelsa 0A 9b(o24o CELL PHONE ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER B L ❑ Architect ❑ Tenant ClAgent ❑ Other (Describe) CONTRACTOR'S REGISTRATION NUMBER (COPY of card required with each application) EXPIRATION DATE c L A N R E 9- E C -P0 SPD 3 ©j Zoog COMPANY NAME APPLICANT NAME OFFICE PHONE A-rc- AS$ c4a -Tw C . leEu y X LZO E (��' 3 ) 48 ff - D Sts MAILING ADDRESS 1)$2SSl, C.feev)a1kr �L'L 'c ZD a ,CITY, STATE, ZIP 1J Qfd P- "172-23 CELL PHONE (`l71 ) 71q -$SCJ RELATIONSHIP TO PROJECT 4 FAX NUMBER ❑ Architect ❑ Tenant ClAgent ❑ Other (Describe) (6-63 ) b 2 y - lS NAME PRIMARY PHONE E-MAIL ADDRESS -os 25 xot .,-4we-ea4ca�6cu NAME Per RCW 19.27.095: Lender information is required il'project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP PHONE ( ) EXISTING USE PROPOSED USE EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK L!C_ COX) 0 SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) 0 PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING SQ.FT. PROPOSED SQ. FT. TOTAL SQ. FT. BASEMENT SHOWERS ELECTRIC WATER HEATERS SINKS FIRST SUMPS BASIC PLAN? o YES SECOND ZONING DESIGNATION CHANGE OF USE? THIRD o NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? ADDITIONAL FLOORS (DESCRIBE) o NO PLATTED LOT? o YES u NO DEMO PERMIT REQUIRED? DECK (0 COVERED OR 0 UNCOVERED?) o NO GARAGE 0 CARPORT 0 NUMBER OF FLOORS morm'—L "OP083D To— "nu amumo si, 7orAL PROPOM sr MAL Sr "*NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. 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 (com ereiao COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG. SYSTEMS PLUACUM BATHTUBS (or Tub/sh�r combo) LAVS (Bathro m Sink* DISHWASHERS RAINWATER SYST DRINKING FOUNTAINS SHOWERS ELECTRIC WATER HEATERS SINKS HOSE BIBBS SUMPS URINALS VACUUM BREAKERS WATER CLOSETS rr.iiq WASHING MACHINES MISC (Describe) I certVy 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 promises to perform the work for which the permit application is made. Z 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 Wormation supplied to the city as a part of this application. NAME/TITLE RELATIONSHIP TO PROJECT 0 OwnerdKAgent o Contractor o Architect I.- - o Other Bulletin #100 — January 1, 2006 Page 2 of 4 k\Handouts\Permit Application o NEW o ADDITION o ALTERATION o REPAIR o TENANT IMPROVEMENT BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? 0 YES o NO PLATTED LOT? o YES u NO DEMO PERMIT REQUIRED? o YES o NO Bulletin #100 — January 1, 2006 Page 2 of 4 k\Handouts\Permit Application