18-105932RECEIVED
CITY OF
QQ ZO18 +Q PERMIT APPLICATION
� DEC 'U
Federal Wa PEST CENTER + 33325 8tb Avenue South + Federal Way, WA 98003-6325
Y CITY OF FEDERAL WAY 253-835-2607 + FAX 253-835-2609 + permitcenteii�icityoffederalway.com
COMMUNITY DEVELOPMENT
PERMIT NUMBER
1_S__ � o 593
IF-� TARGET DATE 5/30/2018
SITE ADDRESS
SUITE/UNIT i
31616 6th ave sw
PROJECT VALUATION
ZONING
ASSESSOR'S TAR/PARCEL f
$ 5000.00
0721049097 _
TYPE OF PERMIT
❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING IN FIRE PREVENTION
NAME OF PROJECT
BURLAKOV residence
PROJECT DESCRIPTION
Detailed description of u)ork to
install an NFPA 13D fire sprinkler system
p y
With a back-flow device
be included on this permit only
NAME CHERNIKOV+LISITSYN+BURLAKOV PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
>LMAM
CITY STATE I ZIP
NAME
Evergreen Fire Protection, Inc.
PHONE
253-381-4456
CONTRACTOR
MAE=Q ADDRESS
PO BOX 998
E MAII
Evergreenfirepro@msn.com
CITY
Puyallup
STATE
Wa
ZIP
98371
FAX
WA STATE CONTRACTOR'S LICENSE • E8PIRATION DATE
EVERGFP967LZ 12/ 208
FEDERAL WAY BUSINESS LICENSE i
20-05106411-OOB1
NAME
Same as above
PRIMAKY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL.
CITY STATE ZIP
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
Mike Hutchinson
253-381-4456
MAILING ADDRESS
PO BOX 998
E -MAD.
Evergreenfirepro@msn.com
e individual to receive and
respond to all correspondence
CITY Puyallup waSTATE ' 98371
PAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
(RCW 19.27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify 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 filled 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
igformation supplied to thecity as a part of this application.
SIGNATURE: -I iVyA +�� DATE 12/17/2018
PRINT NAME: Mike Hutchinson
Bulletin #100 -January 29, 2016 Page 1 of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how many of each type offtxture to be installed or relocated as part of this project. Do not include e;dsdngftctures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (caa)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
Indicate how many of each type offixture
to be installed or relocated as
part of this project. Do not include existingfoctures
to remain.
BATHTUBS (or Tub/shower combo)
LAVS (Hand Sinks)
TOILETS
WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
❑ Yes ❑ No
DRINKING FOUNTAINS
SINKS (Kitchen/Utility)
WATER HEATERS (Electric)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL ARRAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
EXISYDiG/PREVIOUS USE
LOT SIZE (In Square Feet)
MUSTING FIRE SPRINXI" SYSTEM?
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
❑ Yes ❑ No
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION Area in Occupancy Group(s) Construction # of Additional Information
Square Feet Tune I Stories
ADDITION
COMMERCIAL — REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area in Occupancy Groupie) Construction # of Additional Information
ware Feet a 8tories
TOTAL .
TENANT AREA ONLY
Bulletin #100 - January 29, 2016 Page 2 of 2 k:\Handouts\Permit Application