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13-101368 0-4A-, I 3 - LO _i_ 3 a, 8- cm... Way PERMIT 11,1F CO ME EL PL DE EN Z2) Federal t C01253-8351'DEVEAX253-835-2609 53-TSERVICES5-2609A PLICATION � E EIS D • 253-8352607•FAX 253.83 wwo.cituo ffederalwcw.com .......... gliWEINg ....32;;;;DR;3 ................................ :..,;..ii??:.•x•} :::?{•>:-.;{:{?+.tt{•:{u-:?{.>:{r.{•ry»:c?:4:•iix..:ry:{{•:ryy:}•{{?.}r.�.:{;..}•:•.{•}:{{•}::::r.r:::::,:::::{;r. ...............:.. '� ,prS I 7Q/ S. 3201' (-�cl erVicky, Wa, cl B 3 CITY OF FEDERAL,WAY SUITE/UNIT# ZONING ASSESSOR'S TAX/PARCEL# A e o 1 a ( 0 zf _ Ic' o g.- rxxvx:..xfxxiox...... x4.....ww..../o vxte••: m «... :..........n ..... v... Swv.. }...... �.....n.....}{.r.•..4 NAME OF PROJECT x ...•,. (Tenant or Homeowner Name) !V DD Yc3r' 2 t.A x^l tc 4, iThr i ,o C 0 BUILDING 0 PLUMBING 0 MECHANICAL. TYPE OF PERMIT 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING t FIRE PREVENTION PROJECT DESCRIPTION R601‹ u` d AY-)3 ,L1 R—elcya. - .,re_ 51,�p S j ilii n Detailed description of work to S y3 O t7. P C€ en ' ()EEC1 (� 1 1 ff €. �, ���V7 be included on this permit only 1/1,0006j a -j- C heAfv t C Ce C ...................................... •r}..,:•r/:-iii:•}}}£4':. ...... .................................... :::r:r:r$$$:•$$$$.{{:ii{%l•$?i$$$$�$i$:�r::?�ir•i:;:;ihi}}fjliY�':rr... r.. «}}}'f.:ivryri:•i:•}:•i}i:4i::i::.... ....::::....................r.. ........................ :::::::{ r::x:•:r:x«:}«v:x+i:::, «:.:.•.:.}{r ...«:{rryx .r x:::l:r n?vmv}r...•::r:x::::!:::rry,r:x., : ry.;.:.x.r•:•x::::r:x:r:x.•r:r:«:«:r.,..v:v:v: :::•:v::....;r : ...................... r}n•::::::.•r.,vr ';rrry•«rf;{.3r}$:.r.{.$ x 5 Fir xrx r «r$r}}i•x:rr. •I.nrr.$rrrr. .•r.•fil::v::r::::xv«: r.,q«rr..r.r:::.Av• ::rr::r.r: :�...rxr:x..:x:r$.:r. :: r?r ... r.rr:.r.x:r..r.. .., :r:?::{. .. r...•r::::.:$}}»;i}i.�:ry;:r. ........... ::::$`$$$$$$'!.•..:.•::,-r::.. {...}. .r: .. .. . ..r r .f r.r: :.srs. :. r.:...r.rx:::r,..r::r.r: ...... r:...r.../.:...:.r..:•'•$'.•i}•r{::,::r;:{::;•i;;:y:.;,}»:•i}}:-:pro}}::: .{..:�:.,�.:::??{{tr.:.�.{:.$r..«.r r:r..r��•:../�.: �:-•:•:::,::{.,:.}:;{{:x r :.: r r.{{i:«r......r«.�$$$rr«:•r:x:: . :rrr .: : r.}:r:frrr:r:rxr::r::::.�$:;{{.}:{r ..... ..r. . . .. .,:. •:rc::::::.,•::rr:...:r.::•.....r.:.....r..,....,.:::rr::::<x:::::::mr:;ff}r::$�s#,:r.{:{.;�"{,{.r�{v{:{:{.;.::??r,.�;,•.<,t', -: rs..r:r:::x........:...,-:...�'..;r.:{,.,.rrsr ...r.r:.r..:r..r::::,.r:::,{.rr.,.,r/:,::/.::::::::::::::r::.:::.::r.. x:. :........ �..f•..r'�i. .... r..:.r..r.....«.n..rr...nn..r$${Ff,.:?:{�{t�tir?::r/.•}X{t{{^tri}.`•}:i$:•i:f.nrr:.x.:.v...v:{till{r{:{::::rr:::, .r::v:::: : ::x::::: :: ......y..:.F. 5$`%'$f::$:::'•.?�::>:•i}y::.t}t:;�:Y•;:;:. NAME PRIMARY PHONE PROPERTY OWNER ( ) - MAH.IItG ADDRESS,CITY,STATE,ZIP - E-MAD; OWNER IS ALSO: 0 CONTRACTOR ❑ APPLICANT 0 PROJECT CONTACT PROtARYPHOO • CONTRACTOR :17. A�D�V'� ernw y4� c& ek),un31 ((22130:))33cIOD- `134 OOf ,,..„, , 5U 1 _ WA STATE CONT ACTOR'S LICENSEEXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# 5 �1NDt5S2.10f O cp ' (fa 13 1A-49-10(00a-b0-B `, \ U rPRIMARY PHONE APPLICANT NAIIM cif'I W C - he(, (dao )3`ib- <1,3O0 MAILING ADDRESS,CITY STATE,ZIP 2666 AV-(36(--(� sr 3tthe) c�J , �grC)y (20� )JUIDF�`/JOf PROJECT CONTACT NAA�ME l PRILARY PHONE (The individual to receive and l�as--AT y Wb 1 v'e C'V1 (Z p b ).34/b -(1 j D o respond to all correspondence MAILING DRESS,CITY, ATE,NIP < '1 �y. �' 7L FAX concerning this application z606 At✓'(JCY''-V l�(v s, 5 Cite I WC c v l (2t7 4, )J 1© - , 33 ALTERNATE�"�NAME: PRIMARY PHONE E-MAI. Dave. Ccksen (2* )3`!o -e/3DO � f i•ea ledc1.nsc . Cowl PROJECT FINANCING NAME Required for projects with El OWNER-FINANCED value of$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PRIMARY PHONE PCW 1927.095) ( ) - I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best of my knowledge,the information,submitted in support of this permit application is true and correct.I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit.I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal Laws regulating construction or environmental laws. I further agree to hold harmless the City ofFederat Way as to any claim(including costs, expenses, and attorneys'fees incurred in the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out oft reliance of the city, including its officers and employees, upon the accuracy of the information supplied to the city as a p o _ •.plication. i 411 SIGNATURE: /,,A,/ / /� / DATEI PRINT NAME: ' O 1 Utr _ v 1 Bulletin#100—January 1,2010 Page 1 of 4 k:\iandouts\PemutApplication Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE PROVIDED) Indicate number of each type of fixture to be installed or relocated asf this o art p project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) • AIR CONDITIONER FIREPLACE INSERTS HOODS(commercial) BOILERS FURNACES HOT WATER TANKS(Gas( COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES ....:::.::.:....................... Indicate number of each type of fixture to be installed or relocated as part of this project Do not include existing fixtures to remain. BATHTUBS(or Tab/Shower Combo( LAVS(send sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/unity) WATER HEATERS(sed HOSE BIBBS SUMPS • WASHING MACHINES OTAL FI S PROJECT VALUATION WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ 22 843%'� $ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPR NBLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes❑ No- Yes 0 No AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE FIRST FLOOR(or Mobile Home) • ENI➢k'hQO� - COVERED ENTRY ......... .. ......... GARAGE 0 CARPORT 0 47Fi3ER eesE e Area Totals = PROPOSED 7021'' ESTIMATED SELLING PRICE$ #OF BEDROOMS AREA DESCRIPTION Area Occupancy Gron s Construction #of in Square Feet p Y P( ) Type Stories Additional Information ADDITION AREA DESCRIPTION Area Occupancy Grou s Construction #of in Square Feet p Y P( ) Type Stories Additional Information TOTAL BDILDIHfr; `::. TENANT AREA ONLY • �r AREA alta x Bulletin#100—January 1,2010 Page 2 of 4 k:\Handouts\Permit Application r1