18-105042City of Federal Way
Commmuty Develop-ent Dept.
33325 8th Ave S
Federal Way, WA 98003
Ph: (253) 835-2607 Fax (253) 635-2609
Building - Multi Family
Permit #:18 -105042 -00 -MF
Inspection Request Line: (253) 835-3050
Project Name: MIRO AT DASH POINT APARTMENTS
Project Address: 30932 19TH PL SW Parcel Number: 122103 9006
Project Description: gPP - Inspection of fire damage. ***NO construction work approved under this permit***
Owner
Applicant
Contractor
Lender
NIIRO AT DASH POINT
INTROSPECT CONTRACTING INC
31004 19TH PL SW
4526 80TH AVE W
FEDERAL WAY WA 98023
UNIVERSITY PLACE WA 98466
Census Category: 434 - Residential alt/add - no change in number of units
Includes: #1 #2 #3 #4
occupancy Class:
Construction Type:
Occupancy Load:
Floor Area (sq. ft.)
Additional Permit Information
Mechanical to be Included? ..................................... No Number of Stories................................................... I
Is this an Online or O.T.C. application? .................. Yes Permit for Building Shell Only? .............................. No
Plumbing to be Included? ........................................ No
PERMIT EXPIRES Tuesday, 23 April, 2019
Permit Issued on Thursday, October 25, 2018
I hereby certify that the above information is correct and that the construction on the above described property
and the occupancy and the use 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:
-. I 41k
CITY OF
Federal Way
DECEIVED
OCT 2 5 2018 PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
3 6 C(3 � N`"^ P1 W A %0 -z
PROJECT7VUATION
ZONING
ASSESSOR''S AX/PARCEL #(/ v o6—
6—
TYPE
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
/n�
a o, a (' S C G dr ,
IF t
be included on this permit only
NAME
rp s Z
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS rl
�do
E-MAIL
Su�J k/r r
STATE
cj
ZIP
9)612--
NAME/j
TAro 4 60 t3 c,0 -x a
PHONE
aS3- -3 - a SSS
/MAILING ADDRES
-1 3D ASG W e 5 f
E-MAIL
CONTRACTOR
CITY/�
Pl�`�
STATE
ZIP
9glq�,o
FAX
U,J�vlrS�
Lvh
WA STATE CO RACTOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
NAME //
PRIMARY PHONE
APPLICANT-
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACT
NAME�.`
f W b C1A h r' 0
PRIMARY PHONE
a - 3� ? ' G 3 77,
MAILING ADDRESS
1'1 b A V t- Lj
E-MAIL
(The individual to receive and
respond to all correspondence
CITYn/�
UA,.'l c'r s'
STATE
wq
ZIP
FAX
concerning this application)
PROJECT FINANCING
NAMEA
❑ OWNER -FINANCED
When value is $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.
1 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 the city as a part of this application.
SIGNATURE: -7�( DATE S /
PRINT NAME: A ✓ L g iB
Bulletin #100 - January 29, 2016 Page 1 of 2 k:\HandoutsTermit Application