18-103456RECEIVE®
PERMIT APPLICATION
CITY OF ��� �
CITY OF I lll/ay 2018 PERMIT CENTER + 33325 8 Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(alcitvoffederalway.com
CITY F E: EI= ?AL WAY
C®MMu ; l` L `r'"LOPMENT
PERMIT NUMBER _
® TARGET DATE
SITE ADDRESS
2 5-6 S 326 ,�� 57�ee'�
SUITE1UNIT 8
6 3 0
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL 6
$ 1-bgo, ani
CC - -C
- 6[ 7 $
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION
NAME OF PROJECT
}-1 eel`
PROJECT DESCRIPTION
Detailed description of work to
f
'To f" a vt � el s d ` GC V e r6lP � Cx- ]_ .
be included on this permit only
NAME
D(A1' FW LIC PRIMARY PHONE
PROPERTY OWNER
MAD.ING ADDRESS
&-4z,5- //b}a Ave vbi lA n ; } ( 0-6E MAD
czTYtc,rVICAnd
wA I
zmq$033
NAME Cd fgffa S�a�es FiNZ
fe
MAUMG ADDRESSE
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1 N b V'5 A),r
CONTRACTOR
CITY
�P M6Y1c
WA
�{`d�S �{zg-iss6l-3036
WA STATE CONTRACTOR'S LICENSE 8
Lc'05!-e5F
EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 6
13 C.F
TGmn L;PRI_ PHONEs- z6�3
APPLICANT
MAHMG ADDRE88 E-XAM
o4bAd silt 95 I'OMM •L'.@W3n°tcs
CITTSTATE
IZ+9ciYY�C+�d
WA
ZIP FAX
q`�f0 5 y25 --0Y 3-036
NAMEPHONE
-r® % , Z S - -2673
PROJECT CONTACT
m id 36-f
(The individual to recewe and
respond to aUcorrespondence
MAILING ADDRESS WMAM
1 q & 90 NE Qs-", 5'P2@ f i u(N. } 16F) Tdtrm , L°,GGl95FP. NS
CITY
STATE
I ZIPFAX
r% s X12 g - tifs i- 3C 3�
Concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAU,ING ADDRESS, Crl'Y, STATE, ziP PHONE
I Certify ander malty of perjury that I am the property owner or authorised agent of the property owner. I certi& that to the beat
Of my knowledge, the igformation submitted in support of this permit application is true and corraecL I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorised 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 costa, 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
ir4/ormation supplied to the city as a part of this application.
r
SIGNATURE: `' i DATE
PRINT NAME: T41'h
Bulletin #100 - January 29, 2016 Page I of 2 k:\Handouts\Pemiit Application
M A.
VA
MECHANICAL PERMIT WE OF MECHANICAL WORK
Indicate how many of each type offbdure to be installed or relocated as part of this project, Do not include wds6ngfictures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS )Commerce)
BOILERS FURNACES HOT WATER TANKS (o-)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
GENERAL INFORMATION
CRITICAL AREAS OF PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
Construction
# of
Stories
Additional Information
NEW BUILDIFG
ZUSMG/PREVIOUS USE
LOT SIZE (In Square Feet)
=S=G FIRE SPRIIQRLER SYSTEM?
$
Indicate how nuing of each type offixture
to be installed or relocated as
part of this pnoject. Do not include exis
' res to remain.
BATHTUBS for Tib/shower Combo)
LAVS (Hand sink.)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
Q
DRINKING FOUNTAINS
SINKS (HI—n/u-tA
WATER HEATERS (®ect ic)
TENANT AREA ONLY
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIRTUREB
GENERAL INFORMATION
CRITICAL AREAS OF PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALDE OF EXHMING IIM@ROVE�PIR
Construction
# of
Stories
Additional Information
NEW BUILDIFG
ZUSMG/PREVIOUS USE
LOT SIZE (In Square Feet)
=S=G FIRE SPRIIQRLER SYSTEM?
PROPOSED FIRE SUPPRESSIOR SYSTEM?
ADDITION
Yes ❑ No
`(Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
........................................................................................................................
BASEMENT
FIRST FLOOR (or Mobile Home)
........................................................................................................................
SECOND FLOOR
........................................................................................................................
COVERED ENTRY
DECK
........................................................................................................................
GARAGE ❑ CARPORT ❑
.........................................................
OTHER (describe)
Area Totals P6 PROFOSED TOTAL
**JVWHOIM oiVLp**
ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
NEW BUILDIFG
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
TOTAL BUnmmo
716 2 q 5-
Q
TENANT AREA ONLY
, f
PROJECT AREA ORLY
` _
.L �O
1
Bulletin # 100 - January 29, 2016 Page 2 of 2 k:\Handouts\Pennit Application