19-101869 RECEIVED PERMIT APPLICATION
Federal
>l/1)ay APR 17 2019 PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
�/ 253-835-2607+FAX 253-835-2609+permitcenter(hcityoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER 1 V:71 — DQCV
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TARGET DATE
SITE ADDRESS SUITE/UNIT#
6Zd S 4- St- tot
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ (9oa b ci ► 0 `'i7 7 ..
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 0 DEMOLITION 0 ENGINEERING & IRE PREVENTION
NAME OF PROJECT g0 ts. . $ .1 C,-.td 14- t) yi (1P�., \"
PROJECT DESCRIPTION Add 'v o`JI*ea-4(\e,- vt of �nvieel 17.-,--41- , ,L
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Detailed description of work to F/4 5i s- ` M
be included on this permit only
NAMEP-'V1/4' CC ( _Nra. 0112 ^ PRIMARY PHONE
PROPERTY OWNER MAILING ADDRESS (j/' L ,LF E-MAIL
CITY STATE ZIP
NAME „,.Si5 Aw) S.e- Vice 206--301_fIIt
MAILING ADDRESS MAIL
CONTRACTOR 0 Go”( 5'7.3 a r•Id 15%}„R I es,µ�(1,u-)
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