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15-104798lir *MEWED CITY OF'OA sEP 212015 PERMIT K PPLICATION Federal Way CITY OF FEDERAL WAY CDS PERMIT NUMBER ) 5 _ ' o 4 ---1qV� _ - - - - TARGET DATE SITE ADDRIESS 8 e -- I ' SUITE/UNIT# PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# � ® � _ $ I(' (5CI) 2 CI 0 .7 (lB TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING FIRE PREVENTION NAME OF PROJECT rr d, 2.i"V 1/\ C, k---tI++ C\‘( ¢ S o p r(e 5 s 101'l sy S X-e 1.4,1 PROJECT DESCRIPTION " s J Detailed description of work to I " 4 CA..eqVtpo 1 Q_Q r d � Kg S be included on this permit only pp NAME PRIMARY PHONE PROPERTY OWNER jC(-141 L P co -}-10%:.:- (A 1 , t. c MAILING ADDRESS E-MAIL us S. -se-ea 4-u c- CITY STATE ZIP T-.2J-!'a ( W.A we ggoo NAME PHONE 'TEl/as R N2 foo I 206 6(7 He/ S MAILING ADDRESS ( E-MAIL CONTRACTOR IILI6 Cl 19 a,./(44 1j (../4 s txtor'‘<9 O,F,"l'e GD.Ctm(•0:9144 CITY STATE ZIP FAX 'a(-1+CZ.211� W4--- Ctt8(66 WA STATE CONTRAST 'S LIC NSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# Tait- Vil 8S '.Tc,.., /(6 / r6 NAME _PRIMARY PHONE E ti-4--5 fi fid( V mW J 2.00 4(7 40 S ( MAILINGADDDRESS` p� f /� APPLICANT 1 f.(f? 11 <R►� 12 Q ittil tJ lv1 S(� E-MAIL .��1-i/d 60,01 CCS.'`^ CITY%v ft 4. .- +TE 8 (6 6 FAX NAME PRIMARY PHONE PROJECT CONTACT (The individual to receive and MAILING ADDRESS EMAIL respond to all correspondence concerning this application) CITY STATE ZIP FAX NAME PROJECT FINANCING 0 OWNER-FINANCED Required value of$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 t - ' as a part of this application. I SIGNATURE: ""''' DATE ©q Z((Tot PRINT NAME:��. .. o4 -e5, Bulletin 5, Bulletin#100—January 1,2013 Page 1 of 3 k:\Handouts\Permit Application IP 11111 VALUE OF MECHANICAL WORK MECHANICAL PERMIT $ Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include exi sting fixtures to remain. O AIR HANDLING UNITS FANS GAS PIPE OUTLETS (Describe) ) AIR CONDITIONERFIREPLACE INSERTS HOODS(commercial) BOILERS FURNACES HOT WATER TANKS(Gas) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTINGGAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include e 'sting fixtures to remain. BATHTUBS(or Tub/shower combo) LAVS(Hand sinks) TOILETS WATER PIPING DISHWASHERSRAINWATER SYSTEMS URINALS OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(e etric) HOSE BIBBS SUMPS WASHING MACHI) S TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SP- KLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Ye: ❑ No ❑Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPO- D ...;,.,,..4,-..?,.;-,,,.- TOTAL1. FOR O..._"FFICE USE 7/.;:w,,,,,,:v ' ' / � ' �i '" //f% s� ���� `r/ �' f'�� /4/ f tr�� • �rr /! - ��; 1! y0r �f yy�✓" �.ff „ 1 j✓ �ly4I�'��r ,u ...._._-. FIRST FLOOR(or Mobile Home) ___...._. .._. l`%%.,r',%//✓/rtr4b (67/40 r} /l//rr/ r ,,,.1 r ,/r/ / 2 / f '� ® r .�^ ,+ d�',`4!,,,-;, r h ,ws:' o ,,,, ,: '' ,,K+ y trr Ef t>,, ,, Arm ;,', $¢" ,..„. /t�J!/„%,r�%4/ ./.i.;,/,', /,' //' .-,,,,,,.;`4.%.6(:,,,,,.• %:,,,/,2y,,),,,..1.�.. .7,0; ,.�.r".fir„`,fi,,�F'.� �i ry/cam COVERED ENTRY --• wzyg'rr•'r� `ice./ ./ /'` .,',, / - i,r W/. !/ i A, " !r/ f .,=7- ,1, f}/`„+ vr1 / %/£.i• 4t��.,,,r //l�L/ �/ �,Orf / •r /y, / f / 1 /lop n//� yf/ ;•� tX`l' '/ �, frz�P��r /"� ,`rF rr"�r�l � r"/,+r�/ ��,�f�.,,. �� �//`�,r`�,rr r/�,r„: : ,r as', A't„,g oo'; riifrrr r�/r;rc!,/rri�/r�,r ,r��dj r�r r.,,rf f., ,�. 'r.�*r .� GARAGE 0 CARPORT 0 . .9 rr.. / , � -----...._-- _.._..�_._..._........_..___— '7/ ' ' / l// -,/.,/,--,-,/-,6/ / /,T=.,-//,,,0/4,.. / 4 /r / � r � � / `r 0/ ' r �i'/ / / nif ti/,fv�/,r% / /l �/ .nL a , rris. /�.. /,r„r✓ �.r r ,,,,,..----,/,/4/-/--/,,,,,,,y /r� 4 �./:sM 3 „ , EXISTINGPROPOSED TOTAL Area Totals <,y�/�,,,r`r, /i',./o r r,, iazriA lc:r'=r✓r,`„ . ! .i rst y 4:r,,rC p�,' a, ;, ; ',;.,, ; „j y£l.,C/.,..,r'/.///.,/c.//./.rwri, .,.f� ,O �O+l!�' � .�,. x: � n ESTIMATED SELLING PRICE$ I #OF BEDROOMS COMMERCIAL—NEW/ DITION AreaConstruction #of Additional Information AREA DESCRIPTION Occupancy Group(s) Type Stories Square Feet /rr�'” f,,,rrr�rr>��, ^� ��,;,,,�',,,;y �'�ff�~ ,/, „ r,,,s ,�,,.r,ir. .,< < ,r., / ,.,�sr„N,���' /.._.,."+r / //Fz,�F/�t d/�/F/, `/ �!. ,^;✓`rr,`,',/,/'/J .:.b',',"', � G q,/� /.ter/ �/`i1'r%�. /l/y�,%✓��/.`4 D�I�'`rj,�'/` %%, s'!/f /F,:»', ��F. ��/f/%fr'%�� ,/fr/,�`':'�/*�irj r„r ,%'/'/ , f.!// ,�,� / �/ r ,�� f�,�/`3�r” '� ADDITION I COMMERCIAL—REMODEL/TENANT IMPROVEMENTS AreaConstruction #of Additional Information AREA DESCRIPTION Occupancy Group(s) Type Stories in Square Feet m.>' /,C ,�..j ,, /4., ''/ //,r r , / „;„,:?;<:N5/ 4,-,%F „,„, ,rr/,F ,/'�;,o,„*w;u 1 s„,,01 �„ ,,/,,;t,F ”;m'+ /i,ly,,,' '',"-/""'''''"x”'/ „l/l'///4 ../,,%/'/r/„„ %;„,„,;,p,`°'m,= r/ , it/ K�, ,/,',',,/';-;,'.*%,42,„104",',; ...x `" ,, ., rr l%r �r/',l it ,tIN ,A, yfn ,,,;,,/B1fIL ,,- ,,,,,,i7;,,-f.-,,rfi'^'/1/4":,'f/ 7 '. ,, /. �-. ,,,,,,,t-.<7.,,t lir ,, i.,:%,., _,,7 r.,, , „ / r'f A TENANT AREA ONLY / i ; ry'/af r / rz'',//, ;:"..;Z;,;/,:',t-,,:!n/ ' Sri / /. /, /r ?!,l '4 p1 /// etr, €� G0 , . .lF Z 4,„ '7';",x.,;.,7,7;-,:;,:;.!"i- / l„` // ri mr1 _' , , ,., ` . Bulletin#100–January 1,2013 Page 2 of 3 k:\.Handouts\Permit Application