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01-103904 ! 0 tt� — CONSTRUCTION PERMIT APPLICATION �� L3Y ' - ` ��© APPLICATION NUMBER: 01-`42,.-5. G- C��--- APPLICATION NUMBER: - - OCT 0 5 2001 APPLICATION NUMBER: - -- - -- - **The Kil tteR fit? drtlitVitiformation—Please print(in ink)or type** BUILDING DEPT. Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. _ .,- - .- .,-_ t ) t-C co iAT-DN SITE ADDRESS: )I 9.-5,'S, SW '5C 1\51-- Su la- ASSESSOR'S TAX/PARCEL#:Z cZ✓cv 3- (Qp e/(' LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): c\ca S \ \I CI,0 c. rcr*. S 0,9h-- S 4-01A-- 1 ,.:4..r.., .,, '?,,"A:ION TYPE OF PROJECT(This application): 0 BUILDING 0 PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERINGFIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): NV\_.S i,4.0.1k\-Z oA_ c U.,L So 2 - cc,-).--v S yj 11-4_4____ ` PROJECT NAME:1--\,\. � - /'kt PROPERTY OWNER: NAME: DAYTIME PHONE: WAS s Su,56n S 0 (2S3 )qz1 -oy96 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): I CONTRACTOR: NAME: DAYTIME PHONE: I 1 61-- \N-0 0 0) c\,c. .-64,4, kl_k)u S ('c ) 32.z-o 9q G MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: G too ‘'I— A vs- S ri}-(P ‘,.1\A- Heti ( — ) r" CITY OF FEDERAL WAY BUSINESS UCEN NUMBER: FAX NUMBER: - - ( ) - CONTRACTORS REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) I / APPLICANT: NAME: DAYTIME PHONE: 0r v`a<N'\b S O'6?Y\(&\._ (2 ) . 2.6 -.l (/6 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: ( \ t RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) - E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR . ■ DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: _ PR" �"j DEON IMPROVEMENTS: figii ' arc.? SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) 1 ...NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PRO3ECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: ■ FIXTURES - Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC 0 GAS PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City of Federal Way as to any daim(induding costs,expenses,and attorneys'fees incurred in the investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only where such daim arises out of the reliance of the city,induding its officers and employees,upon the accuracy of the information supplied to the city as a part of this application. NAME/TITLE: S� 1/�olv� S r r Y`�Sk DATE: /0- 5. 2 c_J ❑ PROPERTY OWNER p-APPLICANT ❑ CONTRACTOR FOR OFFICE USE ONLY:-1 '❑rNEW ' :-:❑=ADDITION -❑ALTERATION ❑;REPAIR . --❑ TENANT IMPROVEMENT CENSUS CODE: "-` -LOT.SIZE:_;._ •. rZONINGDESIGNATION;s , BUILDING SHELL ONLY? ;.❑ YES 0 NO - �COMP.,PLANtiESIGNATION BASIC PLAN?-' -TO YES ❑ NO' - SECTION;:=,u -_TOWNSHIP RANGE NEW ADDRESS REQUIRED? -❑ YES ID NO PLATTED'LOT? . 0 YES El NO CHANGE OF USE?. ❑YES 0 NO COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY;WA 98063-9718•253-661-4000•FAX:253-661-4129