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10-102824Federal Way ('0MWP11TY DEVFL01VENT .SER47(.F.S 25.:-6 35-2607• EA,%� 253-8:35-2609 PERMIT Rec WeD-p ME PL DE E FP APPLICATIONjuL 01 pV ��3va OIC' OF FEDEPa s SITE ADDRESS D aa�J� SUITE/UNIT # 109 �w 3 17-�h �-rn�-r PROJECT VALUATION $ t2, 000 ZONING ASSESSOR'S TAX/PARCEL # D � 2 / -0 4--- _ q Z l q - TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING FIRE PREVENTION NAME OF PROJECT Name/Homeowner Last Name) ( �+� ('/'enant J PROJECT DESCRIPTION NLvli�rM j ©"4t_t' AN 1e-- Detailed description of work to be included on this permit only D PROPERTY OQPIV��,.,/ // r l/ � PHGNE 7 % MAILING AD ' l E-MAIL CITY i STATE y ZIP NAM C4 A_r(il� kF S FHS-r7e . 2'!�'2— Ot�lJ MAILDIG ADDRESS 32a S 57 E -MAH, Vr CONTRACTOR fUooe.. CIT4�( STATE ZIP � FAX WA ATE CONTRACTOR'S LICENSE # CALE fZ6.roi I I �' EXPIRATION DATE FEDERAL WAT BUSINESS LICENSE # NAME �tS ll� PHONE APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PROJECT CONTACTNAS A 1 �'M PHONE (The individual to receive and MAILING ADDRESS 3z b 21 E-MAIL E-MAIL respond to all correspondence concerning this application) CITY �STATE ��t W�- ZIP q�7o'I FAX ALTERNATE CONTACT NAME: PHONE E-MAIL PROJECT FINANCING NAS /'r� �,( cl. OWNER -FINANCED � Required value of $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. 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 this application. apart sof — ' I�,� SIGNATURE: �` DATE A"" q�, PRINT NAME:�� Bulletin #100 — April 14, 2010 Page 1 of 3 k:\Handouts\Perrnit Application J. IV— 0 � 1 VALUE OF MECHANICAL WORK � (a copy of bid or estimate must be provided) Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial( BOILERS FURNACES HOT WATER TANKS (Gas( ---- .__ COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES Indicate how many of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. BATHTUBS (or Tub/shower combo( LAVS (HandSinlm) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (Kitchen/utility WATER HEATERS (aeectric( HOSE BIBBS SUMPS WASHING MACHINES.;:•::..........?,;:;:'`.i.;;'.':<::#?#?:#;: .. .............. .... .... ... ..x x ::.::::..:..•:..,•:•:••::::x::•::::,:+:,:•;::::+:}�:F r:::•: r . .::F.:f,r. ? .:•r•r• .:.::,.:,; • -ri.F:it4`;?:'F.•f: :{.}I•iii}}':?: y r. Ff .r/.•i�17F {{ {vx .. rr {::i :'•}r: +i:: �/•f:.+.'•x :f/x• :: r: ::::.+.:.r r: {r'.ff{.•r // ••r,. ri /:r/%:{.•�4 :• Frf .r r: :. �Jf{,..!?;:i :}. :. v./::. �?:.f . rifif x : �j{,. .f,. �,., ;,:x::rr•.• rF.n.,•}::?3':::.}'.......: ^� � : i:: rf. r{+:>;::/,.•..f,.:.,%#•':•.'•:'•.'• xq':; i`,`:*H:*,! ilii+:. •�rG:kr{i F: }r .r }.fr,. �:;••3/i"/.%:}}r ii:?.::,/,%{rix:.• A/: .: �n •}!J{•: +i: er'3•'Fr r: ir: x.frr r?ti:}{i..;; / ..� �� 3•::<::•i •Ff r r,•.rFif:/•'::.^}}: `%itii4�{3 r :/s:,.• {.:{f„•:•: f+: :.,.,:{.{:::•:. •rrf.+.f mo :;:i:?::F +•::{•,x G.::i'i::.,x:f: {:: r: {..;'.'} :. •i �:. f:�- '� J • :. :}: 'r{:,:.:rJ.+.:+}t;r .:fii:�•,.?�fr.!/.•:•:: :.: :?:?•'.:+:.d-..::::r.bi� • 1: ::{: 4F 3”.?•�+•: y.hf , ,.. ?:::� {:: ;v:Ir::'{{ •:?h::' f.{i{ry`: i}:.::};i {.r r ..; :�Ii .: AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE 333:<33::33: ilii•333>::33::3::3::<::3::3333::>::: 3; --- r:xxx:: r.•:: `#3:3####: ori w:trrx, •:::::: ?{ #:r ?i `#34:c:Y �.';ii{n}vx: -{ '5::� ...:��' �.�..• • •. { -::: r.,•3:::,ti:•}}}:::r.. rx ::::::::::.,•:::::::::::::::::. •: �:3333333:•,'•333:;3::•'::3tii:+•:� i? ........:.....?:. n; {ti3::ii::ii:{#i:%i::'i:: ii:}'ii::333:'LC: �.`•333`•::3i3ii3Y %:.:::xxtr::::.:•: x: m::x r: x::.:.:.....:.::::::.:::.:.nwxx::r xr}' ii:• �S: � {:33:}:•:'r,::i.`•.; .: :rx%r:::i FIRST FLOOR (or Mobile Home) -.—...-----._..._._._....._....__._...__........ _....... _...... ....._.......... •i: is ::};•i;.;y; ......::.;i}}::::r:: ix::r•}:•xrr:x:::r•,r:::}.:::•:::::•::•}}}:•}::•}:•; {.;:•}:•:isi::isi :: i s<iiisis:}•i::::}:::::::::::......... . r:.u.}•:{:,:r.},:?;+}•• '" :wr:•rx :.f+...:. . i>:•}:;;:.,{.: ,•..;i:i :C.•;•'L: 33331,x::. ::,max S•: ,,}:f,•i:: ..:. ir.:.....,::.:.:: ,::r......... r:: X3:33:' .'s�.•�` .''.'�:•V!�:�C'. 3}ii:;:si;:i<;i:::ii}<:;:%;33333{..:.?:.:.'E ..... . COVERED ENTRY :33:;3::;:: �• iz?:>:3•'::: ........:.::•::r...:...................:.::r :.::.:.i:.::•::•i:•i:•}::•.;•::::::::::r:.:::.:•::::r::::.::.:::::rr::::::•::::::r 3� fiiii{333 . t3F•'•'ti ••rrrr:?.:333#iii :::::r:::::•:.. •:::•}:•iii:.;{•::.:::r:r::.•::::::..::.:::{;{:::.:..:.:{:.::{:.;:r.;}:.,.:.:::::::::r:.:::.:}:::r::::::,•::::::::r:r::•::: • .........r:::::k{.:;•i:????•}:{+•;::rrr:::,,..:::rr:.:.:•...:::.:...::r.::.::.,.:.::.x:::::::,•:, r,:.:.::.r:.....:{{:::::::::..:•}:??•:;??•i•}:.}.::::::.,:,•,..;:::::;> :.{.. GARAGE ❑ CARPORT ❑ .�?`C�-• �•:`yy•,3333333,.:�_...;;:>#ii;' :•n:::. ::v{1r: x::nw ^: xii:�{}}; xr::::: .: r:: x ::::: .:: .:.... :.::::::: m:: ::::::::::::::::::::•:::::: x::::. ¢:•i:•x::v:•:::::•i::: r: y;::::,:; :: .; ::::. :....-:: ••: r.+i x{.:.... v::::::+ii}iY.v,.::{x w.x... n.. n..: ..................:.. }: '• �xrr•::::::::::::: xr{.•r:..r.•..:.:r x. x::.::..:::::::::::::.: :x:::: x:::::•:::::: :::.:x:::x:r.:w:::::::::::: x:: xv:...•::w:::: ri:::,x+::� :.. x::+:r::,::xxxr:.:???•}}:}:.w:.:. :: .:\: :?}::: riff.?{i ___.--_--_.____...___. ZMTNG PROPOWD TOTAL Area Totals ESTIMATED SELLING PRICE $ # OF BEDROOMS AREA DESCRIPTIONI Area in Square ADDITION AREA DESCRIPTIONI Area in Square Feet TENANT AREA ONLY Occupancy Groups) I Construction I # of Additional Information q,--.q,--.Rfnrine I Occupancy Group(s)Construction I # of I Additional Information Tvne Stories Bulletin #100 – April 14, 2010 Page 2 of 3 k:\Handouts\Permit Application