The URL can be used to link to this page

14-101363i Cff,C Federal Way PERMIT APPLICAVrON1 MAR 2 6 2014 P911wr NU,u:,e (� '/ CITY OF FEDERAL WAY ------------ TAvWWDATZ CDS apps ADDl SUITZ,UAiT. 9 D_j S6 it 7-1j Com 14 0 e nth L- ;V 1-f \A✓A 6) 84 o3 PROJZCT VALUATiOZ a 95 o0 ZOZIZO AZMZZO7>t'Z TAX/PARCZI, # 76 y©_v U TYPZ OF PZRMT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION NAM OF MMMCT 16 K S 6 a 7 /ti, a U b T. ,4-r 7 -PC- COM Al 0 S D U 10L PJZ / A)Y Loz-- Pgo 1�L 0 PROJZCT DZSCREMON Detailed description of work to b f 6% 7-P a L� f) L--/2 t 4-ki S be included on this permit only PROPZRTY OWNZR ZAtd C- 0 ✓Li M, Q Q S / 1 �� i� L L c PROWS 5) — 07n0 AMMON 0 v 01U KI R- 11-111M its a5tead�a5}cw C1TT STATZ FRONS ltAII INS ADDIZM �h 1 S , t% Lf 5 Tl wmm CONTRACTOR crff S 0 M Ai �lL aTATi zQ 3 9D FA S3 -�7 2 G` 1 d 3 3 VA STATZ COWMACi;W. MCZ # �1RLS ZXPUTATIOD DATZ 2/ 31 /I IZDZRAL WAY aUMtiii MCZAZZ # 22- do 3 - 'Am P fCK L A OG �� >. �;,MY 92IV 3 Imm"S AMAMi S.)- 1f�K S% 97AT u7 ,t I n LMML rtelc ►rc s rim APPLICA1Ii UN1 wA I " 36117 FAX ,thin � t G K � Z -� t� G !� T� ti ,mlARs � ,r -1,931 PROJZCT CONTACT 2 31AD'°la ADDSMt -/j f s L"ITL / U Z /r� t c Y)C ' I r 5 r ► n kl eve (The individual to receive and respond to all correspondence CrT v0AJe2 STATS SQ o�390 TAX concerning this application) PROJZCT FINANCING'IA's L' U e✓l i✓l c� til S +✓l lellr L �- � rULAAUso Required value of $5,000 or more (RCW 19.22095) MAWNS A/yyDOItw� , CWT. STATZ, l { Il�rQ � X500 )Ru))JeX.A 12 0 !!r0lli /y q 44 q - 5,Z -07c o I caIh under pora41 ofperjwy that I an the property owner or outhortsed agent of the property owner. I cerft that to the best of why knowbdge, the information submitted in support of this permit application is true and am set I ewwb that I will een44 with all applicable Cal ythderat Was regulations pertaining to the work amtherlsad by the tesuawae of a permit. I understand that the issuance of this permit does not remove the owner's nrapswsibiNty Jir compliance with local, state, or federal lama regulating construction or envireamental taws. I f krther agree to held harmless the City of Pedwwl Way as to ang claim (Including coats, expewess, and atteradjW fors incurred in the investigation andd4fiwse of elab4 whieA may be made by aryl person, including Ow undersigned, and Jlted against the etty. but only where such a of the reliance d the city, including its eJJ[-ere and emptylees. upon the acaurasy of the i1 brwlattsn supplied the alty tris ? SIGNATURZ: DATZ PRINT NAM- 1 L � `• � %�-' Bulletin #100 — January 1, 2013 Page 1 of 3 k: fiandouts\Perntit Application 2 -,3L- C. rtj to GENERAL INFORMATION el CRMO" ARRAS ON FRosRRTrt VATER PURYirOR sswrre PUMSTOR VALQa of msfUM LOROVveNawrs BAASSMENT Additional Information Row m� mzwr na/rRsvloos oss LOT sun W 81ra— Feet) Ztaum mo nu mm mR m gm=fft FROPOMD nu sumzo IoR s wmp SECOND FLOOR ADRITIOR N,Yes ❑ No ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION ARM DZWRtMOX Jim square feet) ZXIW > G PROPOSED Area in "manfeet FOR OMCE usa BAASSMENT Additional Information Row m� FIRST FLOOR (or Mobile Home) SECOND FLOOR ADRITIOR COVERED ENTRY COMMERCIAL — REMODEL/TENANT IMPROVEMENTS DECK Area Fest in squareTOTAL OceuPu'" OrouP1N Construction GARAGE ❑ CARPORT ❑ laftrmation lb H OTHER (desm2w) Area Totals �. TMAL —xmJp m= OldP* ESTIMATED SELLING P CE $ # OF BEDROOMS COMMERCIAL — NEW/ADDITION ARL► D=CRUTWX Area in "manfeet Oseupsom Oreums) Construction Ty"Stories Additional Information Row m� ADRITIOR COMMERCIAL — REMODEL/TENANT IMPROVEMENTS AREA DSSCRIITiOR Area Fest in squareTOTAL OceuPu'" OrouP1N Construction #ofAdditional stories laftrmation lb H Tznmm AREA onlay iM�rl AREA p1tT Bulletin #100 -January 1, 2013 Page 2 of 3 k:\Handouts\Pemfit Application