14-104864RECOM
CWT OP Federal Way SEP 2 2 2014
0
PERMIT APPLICATION
CITY OF FEDERAL WAY
PERMIT NUMBER t _ U Flo
y 8<6 q TARGET DATE
SITE ADDRESS
35703 20th Ave SW, Federal Way, WA
SUITE/UNIT #
Lo
-a T -• TTATION
$ -'7j 600.03
ZONINGSESSOR'S
TAX/PARCEL #
AS , 5 3 Z4 -z<- AO S -
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING a FIRE PREVENTION
NAME OF PROJECT
Crosspointe Lot #5
Single Family New Residential
PROJECT DESCRIPTION
Detailed description of uvork to
be included on this permit only
NAME
PRIMARY PHONE
PROPERTY OWNER
Brookstone Homes LLC
253-363-1430
MAILING ADDRESS
E-MAIL
33516 9th Ave S #6
CITY
Federal Way
STATE
WA
ZIP p
D�03
NAME
PHONE
B &R Plumbing
253-847-5770
MAILING ADDRESS
E-MAIL
CONTRACTOR
PO BOX 4069
plumbinghelp@earthlink.net
CITY
STATE
ZIP
FAX
Spanaway
WA
98387
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
BRPLUI"099DF
201310172500BL
NAME
PRIMARY PHONE
Brookstone Homes LLC
253-363-1430
APPLICANT
MAILING ADDRESS
33516 9th Ave S #6
E-MAIL
john@brookstone-homes.com
CITY
Federal Way
STATE
WA
ZIP
98 ,3
FAX
N/A
NAME
PRUGLRY PHONE
PROJECT CONTACT
John West
253-363-1430
MAILING ADDRESS
33516 9th Ave S #6
E-MAIL
john@brookstone-homes.com
(The individual to receive and
respond to all correspondence
CITY
Federal Way
STATE
WA
I ZIP
98 3
FAX
N/A
concerning this application)
PROJECT FINANCING
NAMEBrookstone Homes LLC
KofER-FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP'
O
(RCW 19.27.095)
33516 9th Ave S #6
aS2-3G 3- 1!13
I certify under penalty of perjury that I am the property owner or authorised 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 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 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 he city as apart of this application.
SIGNATURE: z ' DATE
PRINT NAME:
Bulletin #100 — January 1, 2013 Page I of 3 k:\Handouts\Pennit Application
i
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offixture to be installed or relocated as part of this project. Do not include e)dstingj1xtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (Commercial)
BOILERS FURNACES HOT WATER TANKS (Gaa)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/shower Combo)
LAVS (Hand sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
SINKS (xitchen/utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FEKTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
XYes ❑ No
Bulletin #100 — January 1, 2013 Page 2 of 3 k:\Handouts\Permit Application