13-100015City of Federal Way
Community & Econ. Dev. Services
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax: (253) 835-2609
JF
-
IsBuilding - Commercial
Permit #: 13 -100015 -00 -CO
Inspection Request Line: (253) 835-3050
Project Name: CAMPUS BUSINESS CENTER
Project Address: 801 S 336TH ST A --pe, A,
Project Description: Inspection of damage to building by vehicle.
Parcel Number: 926480 0190
Owner
Annlicant
Contractor
Lender
NEIL WALTER COMPANY
HODGE CONSTRUCTION INC
1940 E "D" ST SUITE 100
PO BOX 1105
TACOMA WA 98421
FALL CITY WA 98024
Census Category: 999 - Unknown
Includes: # 1 #2 #3 #4
Occupancy Class:
Construction Type:
Occupancy Load-
Floor
oadFloor Areas . ft. 0 0 0 0
Additional Permit Information
Mechanical to be Included?...................................No Number of Stories ................................................. 1
Permit for Building Shell Only?............................No Plumbing to be Included? ....................................... No
New / Additional Sq. Feet - Total .......................... 0
No'Fixtures Associated. With This Permit 11
PERMIT EXPIRES Monday, July 1, 2013
Permit Issued on Wednesday, January 2, 2013
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the us will be in accordance with the laws, rules and regulations of the State of Washington
and the City of Federal Way.
Owner or agent: Date: ( 2
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COMMUMTY DEVELOPMENT SE I ESj P P L I C A T I O N
253-835-2607• FAX 253-835-2609 ^A
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SITE ADDRESSCIT`(
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SUITE/UNIT a
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
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PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
PROPERTY OWNER
NAME :
Nat, WA-t,-ra% eo ,4N
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, PRI Y PHONE
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MAII ADDRESS 0 0
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E-MAIL
CITY
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NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP -
FAX
WA S E CONTRACTOR'S LICENSE M
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 8
NAME
Ha Dfif epmi on i Ila (_
PHONE
(4Z 5 LZ So It
MAILING ADDRESS
110r,
E-MAIL
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APPLICANT
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CITY
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STATE
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ZIP
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FAX
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PROJECT CONTACT
(The individual to receive and
respond to all correspondence
concerning this application)
NAME
I
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1475- W-360
MAILING ADDRESS
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E-MAIL „.
CITY
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STAT
ZIP
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FAX
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ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
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 fried 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 supppli the city as a part of this application.
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SIGNATURE: l/ C c--� �— DATE Z f J
PRINT NAME:
Bulletin #100 - January 1, 2011 Page] of 3 kAHandouts\Permit Application
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