18-105323A
CITY OF
Federal Way
RECEIVED PERMIT APPLICATION
PERMIT CENTER + 33325 8'h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter(&,,citvoffederalway.com
if CITY OF F EOERAL WAY r
MMMUNITY DEVELOPMENP
PERMIT NUMBER _ / a 5 3 A 3 - FtO
TARGET DATE
SITE ADDRESS
SUITE/UNIT k
d oto SW 3510 WA '1'6Da-
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL k
O
D
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING Lid FIRE PREVENTION
NAME OF PROJECT
�j ort sho v�e. IAQOLte. SturAirr,e - BLD ti A
fr 1 2 E SP fl- � �v-�.+�2 1 r� � 1 -R -ll a ,n s...� w e. fi 5 r i v� kl e✓ s}-e.v►ti 1"O
PROJECT DESCRIPTION
Detailed description of "rk to
tk i11'd`L^L V l A' -646
C-1. Fl A►ms
be included on this permit only
NAME
PRIMARY PHONE
F I S I y-% \.Ie s fv,r5C-
PROPERTY OWNER
MAILING ADDRESS
E -MAD.
P v 3dx S11 -
CITY
STATE
ZIP
NAME
NvrthweSt Fid
PHONE
:Zolo 111.750.
MAIdNG ADDRESS
a s to 14Ca 3rD Ave
E-MAILE-MA
Ko r earn) r%WJ4?VtSL)StC4VL1.
CONTRACTOR
CITY
K
STATE
W A
ZIP
I S-1, Z.
FAX cov
tot, 7 -+A •'fisc `i
WA STATE CONTRACTOR'S LICENSE M
IJp21l-1 FS9
EXPIRATION DATE
a0 /acao
FEDERAL WAY BUSINESS LICENSE i
ao -to • 101 143:1• Db-(5L
NAME
}( .lin.: 6 'Rea..r Gr (,i f S44c z-,
PRIMARY PHONE
Zsu
APPLICANT
MAILING ADDRESS
a a lr 4c� X63 �v�e S r3l !7
E-MAIL.
acorea rAab n w t4 rYs Ska+IS.
CITY
KA. -Ilk
STATE
wF}
ZIP
°lssna
FAX L
26to -i 1a .9 so
PROJECT CONTACT
NAME
KA.tt,.z
PRIMARY PHONE
7"Ito firma ' I So 7 -
MAILING ADDRESS
�, 2- is +S —
E-MAIL
KOr`t" aw fi et5
(The individual to receive and
respond to all correspondence
CIT , �
STATE
LJA
ZIP
FAx
concerning this application)
PROJECT FINANCING
NAME
K-N,Zow • W95-
❑ OWNER -FINANCED
When value is $'5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27.095)
'26t*-) t -y 0 PAP CZ L .
I certgy 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 to the city as a part of this application.
SIGNATURE: �V� t�ULAY � (3 (NI%l t V flit F1' l^e S1.�SI'Zw�h DATE 1t O Y .7 l Si
PRINTNAME: KATklI (�'Qei11(L fL Nt�jVuEST �lQ� SySTE�ts
Bulletin #100 - January 29, 2016 Page 1 of 2 UIiandouts\Permit Application
•s
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
I `i �
Additional Information
$ 7&- +ft. -V
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existingfixtures to remain.
AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
V OTHER (Describe)
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (Commerew)
y V
BOILERS
FURNACES
HOT WATER TANKS ices)
TOTAL 11!I11J,pIItQ
COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
�� ^
DUCTING
GAS PIPING
WOODSTOVES
�yI
• '_""VvJ
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
VALUE OF PLUMBING WORK
PLUMBING PERMIT
I `i �
Additional Information
$ 7&- +ft. -V
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
$
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
TOTAL 11!I11J,pIItQ
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Ei-trie)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FEKTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
I `i �
Additional Information
$ 7&- +ft. -V
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
ADDITION
❑ Yes ❑ No
WYes ❑ No
W - a9�'ot.4lbµITn0 C,
L. X
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
k.
FIRST FLOOR (or Mobile Home)
--------------•- ................. _.__..— ... _... _...................
---- – -
COVERED ENTRY
--------------------------------------------------------------------------------- -------- ------------
777�� 777777777,
DE�K
x
GARAGE ❑ CARPORT ❑
Area Totals SIG PROPOSED IWAL
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
Square Feet
Occupancy Groupie)
Construction
a
# of
Stories
Additional Information
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area in
Square Feet
Occupancy Group(s)
Construction
a
# of
Stories
Additional Information
TOTAL 11!I11J,pIItQ
TENANT AREA ONLY
PROhlbT AREA OMY
;
Bulletin #100 — January 29, 2016 Page 2 of 2 k:\llandouts\Permit Application
-
to 17-0 4 - tm
40k
OF
Fed10"::tS:P
eral Way
DEPARTMENT OF COMMUNITY DEVELOPMENT
333258 1h Avenue South
Federal Way, WA 98003-6325
253-835-2607; Fax 253-835-2609
www.cityoffederalway.com
FIRE PROTECTION SYSTEM CHECKLIST
THE FOLLOWING ITEMS ARE REQUIRED TO APPLY FOR A FIRE PROTECTION SYSTEM PERMIT.
PLANS AND APPLICATION WILL NOT BE ACCEPTED IF INFORMATION IS INCOMPLETE.
❑ Completed construction permit application form.
❑ Maximum plan size is 24" x 36"; minimum is 11" x 17".
❑ Proposed project valuation.
❑ Property tax parcel number.
❑ Method of freeze control. N (A', wvt,ol e W'3
AA
❑ Two sets of plans drawn to 1/4" or 1/8" scale, stamped by a State of Washington certified fire protection
designer or engineer, and cut sheets, per NFPA standards, to include:
• Floor plan of each floor
• Ceiling construction
• Full -height cross-section
• Location of fire walls
• Location of walls and partitions
• Occupancy of each room or area
• Location of small or concealed spaces (closets, etc.)
• Water pressure information
• Make, type, temperature rating, and nominal orifice size of
sprinkler
• Total number of sprinklers on each system
• Pipe type and wall thickness
• Location and size of riser nipples
• Type of fittings and joints; location of all welds and bends
of securing sprinklers (when applicable)
• Type and location of hangers, sleeves, braces, and methods
of securing sprinklers (when applicable)
• All control valves, check valves, drain pipes, and test
connections
• Underground pipe size, length, location, weight, material,
point of connection to city main; type of valves, meters,
and valve pits; and the depth that the top of the pipe is laid
below grade
❑ In addition to existing system (above items plus), provide enough of the existing system to make all
conditions clear.
❑ Hydraulically -designed systems; material to be on the hydraulic date nameplate Dr—e.1— i � . J�
❑ Non-metallic pipe; method of protection N IR . A k K .L, r..,.Q
Bulletin #115 —March 7, 2013
Page 1 of 1 k:\landouts\Fire Protection System Checklist