18-102321of
City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Building - Single Family
FILE Permit #:18 -102321 -00 -SF
Inspection Request Line: (253) 835-3050
Project Name: BETHEL CHRISTIAN CHURCH UNIT 115
Project Address: Parcel Number: 072104 9003
Project Description: P - Inspection of fire damage. ***NO construction work approved under this permit***
Owner
Applicant
Contractor
Lender
DENNIS C. AUSTINBE
LOUIE NEWHOUSENORDIC
NORDIC SERVICES INC
CHU ENTER
SERVICES INC
9618 MIDVALE AVE N
414 SE 312TH ST
9618 MIDVALE AVE N
SEATTLE WA 98103
FEDERAL WAY WA
SEATTLE WA 98103
98003
Census Category: 434 - Residential alt/add - no change in number of units
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ..................................... No Is this an Online or O.T.C. application?.................. No
Phu nbin>; to be Included? ........................................ No
PERMIT EXPIRES Monday, 26 November, 2018
Permit Issued on Wednesday, May 30, 2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy the use will be in accordance with the laws, rules and regulations of the State of
W ington and the City of Federal Way. z
Owner or agent: Date: O�
DECEIVED
CITYOF MAY 30 2018
PERMIT APPLICATION
Federal Way PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
CITY OF FEDERAL VM -835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER _ _
TARGET DATE � I
SITE ADDRESS
SUITE/UNIT #
16
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAX/PARCEL # _
) o q C� o
of ew . o p
3
Q -
TYPE OF PERMIT
>GUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
C�L&Ean
PROJECT DESCRIPTION
Detailed description of work to
✓�
be included on this permit only
NAME ' I _
`
PRIMARY PHONE
PROPERTY OWNER
MAILIN AD ESS s7
SW 17
E-MAIL
CITY
I STAV
ZIP
NAME ,
G�
PHO �j 72Q�r`-'7
(/ -2 ( 0
MAILING ADDRESS
E-MAIL'
CONTRACTOR
CITY
STAT
ZIP
FAX
WA S TE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
7-1
NAME
Ul e-- ZA,-)VS2_
PRIMARY PHONE
Ac&571204
MAILI ADDRESS ,
E-MAIL
APPLICANT-
CITY
+moi ..9
STAT
ZIP
FAX
NAME, � w^
PRIMARY PHONE
PROJECT CONTACT
VVV k V 1C��7 S�
MAILING ADDRESS ` A ,
��—
E-MAIL
(The individual to receive and
respond to all correspondence
621� i Vito
Pmt 5
CITY
o
STAV
I ZIP y�
VOW
FAX
concerning this application)
PROJECT FINANCING
NAME A
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CI , STATE, ZIP
PHONE
(RCW 19.27.095)
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 defers a of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such clai ari es 1(ut of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied tot part oft application.
, -(30 1
SIGNATURE: DATE I
PRINT NAME: 6u
Bulletin #100 – January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application