03-100307r �
City of F,eti
RECEIVED
CONSTRUCTION PERMIT APPLICATION
uV i�YL JAN 2 2 2003 APPLICATION NUMBER:
CITY OF FEDERAL WAY APPLICATION NUMBER: _ _ - _ _ _ _ -
BUILDING DEPT, APPLICATION NUMBER: - -
"The following is required information - Please print (in ink) or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
SITE ADDRESS: �J(� �i� WG(5• 13 ASSESSOR'S TAX/PARCEL #: 2 o 2 d - Q (f D
LEGAL DESCRIPTION OF SUBJECT PROPERTY (ATTACH SEPARATE DESCRIPTION IF LENGTHY):tcl�ta I�C� �t CGS �' le r c, k
40A '4�i 4&=NiN6 -am_ _ I , 't _
PROIECT INPnOMATION
TYPE OF PROJECT (This application): ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): rly t C' -PC" 10j f-)pa+k 0 r if P X 5 • � tc. n
PROJECT NAME:
PROPERTY OWNER:
CONTRACTOR:
NAME: DAYTIME PHONE:
V-A Me 56-1k (253 (3
MAILING ADDRESS STREET ADDRESS; QTY, STATE, ZIP):
33c105 rtc:�� u S. T4erc,( (,L��y ieyq �1�003
NAME:
DAYTIME PHONE:
MAILING ADDRESS (STREET ADDRESS, QTY, STATE, ZIP):
EVENING PHONE:
( )
QTY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER:
CONTRACTORS REGISTRATION NUMBER:
EXPIRATION DATE:
(cDPy d card required)
/ /
APPLICANT: NAME:
MAILING ADDRESS (STREET ADDRESS; QTY,
252z( 10:b 441 Au,
RELATIONSHIP TO PROJECT.
❑ ARCHITECT ❑ TENANT
kt Sc- I /
FE, ZIP): 1
5. � . � �3o�s �1�v1 �►
❑ OTHER( DESCRIBE):
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ,APPLICANT
❑ CONTRACTOR
DAYTIME PHONE:
EVENING PHONE:
FAX NUMBER.
EXISTING USE: HOW N( EXISTING BUILDING ASSESSED/APPRAISED VALUATION � S S • SG D
PROPOSED USE: , �rCii,i �L:A 1-4 VkV1f-1 V►i'JI W,MED VALWe4'M FOR IMMOVEMEMMI, V W-A1k "`` �J 1rf46!4 �
SPRINKLERED BUILDING? ❑ YES Wr NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED• DYES ❑ NO -
WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) ,
SEWER SERVICE PROVIDER: 11 LAKEHAVEN 0 HIGHLINE 11 PRIVATE (SEPTIC)
M
**NEW RESIDENTIAL CONSTRUCTION ONLY**
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
■ PR03ECT FLOOR AREAS
FLOOR
EXISTING SQ. FT.
PROPOSED SQ. FT.
TOTAL
BASEMENT
FIRST
SECOND
THIRD
FOURTH
OTHER FLOORS (DESCRIBE)
DECK
PP law
GARAGE
HOW MANY FLOORS?
TOTAL:
AIR HANDLING UNITS)
BBQ(S)
BOILERS)
COMPRESSOR(S)
DUCT(S)
BATHTUB(S)
DISHWASHER(S)
DRINKING FOUNTAIN(S)
GAS PIPE OUTLET(S)
INTERCEPTOR(S)
Indicate number of each type of fixture
MECHANICAL
EVAPORATIVE COOLER(S) GAS LOG(S)
= FAN(S) HOOD(S)
FIREPLACEINSERT(S) RANGE(S)
FURNACE(S)
REFRIG.SYSTEM(S)
WOODSTOVE(S)
MISC. ( )
GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC ❑ GAS
PLUMBING
LAVATORY(S) URINAL(S) WATER HEATER(S)
RAINWATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SHOWER(S) WASH MACHINE OUTLET
SINKS) WATER CLOSET(S) MISC. ( )
SUMP(S)
■ DISCLAIMER/SIGNATURE BLO
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and
further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of
Federal Way, 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 the city as a part of this application.
NAME/TITLE: DATE: /—,Z2
❑ PROPERTY OWNER .PTAPPLICANT ❑ CONTRACTOR
COMMUNITY DEVELOPMENT SERVICES 33530 FIRST WAY SOUTH • PO BOX 9718 • FEDERAL WAY, WA 98063-9718.253-661-4000 • FAX: 253-661-4129
www.ctvoffedmlway.com
W.I.R.B
33905 Pacific Highway South
Federal Way, Wa. 98003
(253) 569-9920
Fax (253) 568-9918
1/17/03
Dear Mohammad,
RECEIVED
.,IAN 2 2 2003
CITY OF FEDERAL WAY
BUILDING DEPT.
Please except this as permission to install and maintain an Automotive Paint booth in the
building at 33905 Pacific High Way South.
Make sure that I receive a copy of all permits and License needed to install and use the
paint booth.
Thanks,
Mik�She
I
West Cost Manager
W.I.R.B.
(253) 568-9920