18-102133City of Federal Way
Community Development Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 835-2609
Building - Commercial
Permit #:18 -102133 -00 -CO
Inspection Request Line: (253) 835-3050
Project Name: TAQUERIA Y PUPUSERIA LA HERRADURA
Project Address: 2322 SW 336TH ST Parcel Number: 132103 9097
Project Description: Fire damage inspection only. ***NO construction work approved on this permit***
Owner
Applicant
Contractor
Lender
TAQUERIA LA HERRADURA.
MICHAEL BRAMHALLJENSEN
BELFOR USA GROUP INC
2322 SW 336TH ST
HUGHES
4320 S 131ST PL SUITE 100
FEDERAL WAY WA 98023
23109 55TH AVE W
SEATTLE WA 98168
gOUNTLAKE TERRACE WA 9804
USA
Census Category: 437 - Commercial alt / add / conversion
Includes: #1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ..................................... No Number of Stories................................................... I
Is this an Online or O.T.C. application? .................. Yes Permit for Building Shell Only? .............................. No
Plumbing to be Included? ........................................ No
PERMIT EXPIRES Wednesday, 14 November, 2018
Permit Issued on Friday, May 1812018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use will be in accordance with the laws, rules and regulations of the State of
Washington and the City of Federal Way.
C 1�
Owner or agent: '�i- `'/ Date:
RECEIVED PERMIT APPLICA'T'ION
CITY OF
g ryn�p PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
Federal Way HIAv V LU v 253-835-2607 + FAX 253-835-2609 + permitcentel@cityoffederalway.com
CITY OF FEDERAL WAY
r,QWKJ'qrrY DEVELOPMENT
PERmiT NUMBER —/ _ 1 6 � 3 2 _
TARGET DATE
SITE ADDRESS
23g..tf- �-s
SUITE/UNIT #
s :33 Cly
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
J
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 1:1DEMOLITION El ENGINEERING El FIREPREVENTION
NAME OF PROJECT
tt
1 � 0 t) E ' )Ar ?� � �V � � L 71 �J� � � U � t � f �l f z £ fZ j?Aj lZ•
PROJECT DESCRIPTION
Detailed description of work to
A)� L tr
\ L
be included on this permit only
NAME
PRIMARY PHONE
�j
PROPERTY OWNER
MAILING AD ESS
E-MAIL
CITY
STATE
ZIP
NAME q
1 (Y� J 1
PHONE
MAILING ADDRESS
43� L
E-MAIL
CONTRACTOR
CITY Z�( STpAT
ZIP l
FAX
WA STATE CONTRACTOR'S LICENSE
2#,
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
�C- _�L V L
NAME
PRIMARY PHONE
-Z-z'� V6 10
MAILING ADDRESS
E-MAIL
APPLICANT-
CITY
P1 0,1j Aq
STATE
ZIP
f° 43
FAX 66
NAME
5?4'l c �5 La Gti�
PRIMARY PHONE
PROJECT CONTACT
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, 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 defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
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 apart of this application.
&:� G� � y
JI-/jb
SIGNATURE: DATE
PRINT NAME: 4 ' l G r� 7" ?ah w -I &Lf—
Bulletin #100 — January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application