The URL can be used to link to this page

08-100094 qvSouth King Fire & Res A, RECEIVEI Approved '' �t of • Detailed a L - 0 ) ederal WaxJAN 0 07 c Iv 1.t a ` : FTdetails >,...4 COMMUNITY DEVELOPMENT SERVICES B SF MF CO ME EL PL DE EN FP 33325 STM AVENUE SOUTH•PO BOX 9718 . - ... ik 6, 7'n FEDERAL 07' WA y7®F FEDERAL W 253-835-2807•FAX fa-83413101N° DEPT, r j 6 �� u+inw.cituoifederu. a e /y The following is required information-an incomplete application will not be accept' Please print legibly(in ink)or type. • PROPERTY INFORMATION s-� k.� 2 \ ``'' �:� ©uth KAi e SITE ADDRESS_ "T ASSESSOR'S TAX/PARCEL# 2 � 2 \ 03 - q d 0 2 Q Detailed L rnr d cue LEGAL DESCRIPTION(e.g.Acme Estates.Lot 1) liJubleet to attar-hed da(t;, (Attach separate page for lengthy legal description) l3 / A IN PROJECT INFORMATION gate -- - - TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ELECTRICAL 0 ENGINEERING XFIRE PREVE'TION SYSTEM'"' PROJECT DESCRIPTION(Provide detailed description of work included on this permit oniu) InSfk61 A. btistc- -Flrc. Aks..ri. 5.�si-re-► r tket1 Qwf icit11s 'A i! Work co(6, PROJECT NAME(Name of Business or Owner Last Name) 1 V or sh't& VII I&5i NI PEOPLE INFORMATION PROPERTY NAMF- PRIMARY PHONE OWNER , NOf V'$ rt- V 11 11 CCG LLG. ( ) - MAILING ADDRESS CnY,STATE,ZIP E-MAIL ADDRESS j o 1Aq Fr e-tvw r? 404. a sca.6I1_, 4,4 `t if/33 CONTRACTOR COMPANY NAME ' APPLICANT NAME OFFICE PHONE 11 Vtre- £f ev�Ci'� Tere..-vt.A- 6•.,.-,s kr./�, ( .ob ) Ras - G/oo s 3o3'ASuSS CJv.r icsTtg,k, $e4t,I -EZIP 4 Ir`3(9-6 (? ONi36 - `-13/3 COY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER a)-0(2HO4 D0 -00 -QL I ?- -D ? - o ( ( ) - CONTRACTOR'S REGISTRATION NUMBERov EXPIRATION DATE E-MAIL ADDRESS q LL.wrc✓E ��1 C oa/o s' CO(wtrce S r.ncr APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE 5•kw►1.-- as ,a 'e_ ( ) - MAILING ADDRESS CITY,STATE,ZIP CELL PHONE ( ) RELATIONSHIP TO PROJECT FAX NUMBER 0 Architect ❑Tenant 0 Agent 0 Other ( ) - PROJECT NAME r /'Cil� PRIMARY PHONE / E-MAIL ADDRESS CONTACT Te-r'e"iau -A( Y 7 (dot. ) 135 - 6l O b Jtr'c.d4.4%0A. '4✓ticr--a-e- G LENDER NAME Per RCW 19.27.095: Lender information is required if project value exceeds$5,000 MAILING ADDRESS CITY,STATE,ZIP PHONE ( ) - • DETAILED BUILDING INFORMATION EXISTING USE • ' • / EXISTING ASSESSED/APPRAISED VALUE$ VALUE OF PROPOSED WORK $ 6 S 0 0, 00 SPRINKLERED BUILDING? 0 YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REgUIRED? ❑ YES 0 NO WATER SERVICE PROVIDER ❑ LAKEHAVEN 0 HIGHLINE 0 TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER 0 LAKEHAVEN 0 HIGHLINE ❑ PRIVATE(SEPTIC) 4r • • PROJECT FLOOR AREAS • AREA DESCRIPTION EXISTING PROPOSED TOTAL SQ.FT. SQ.FT. SQ.FT. BASEMENT FIRST 1 2' 000 DD SECOND l THIRD ADDITIONAL FLOORS(DESCRIBE) DECK(❑COVERED OR 0 UNCOVERED?) GARAGE ❑ CARPORT 0 NUMBER OF FLOORS EXISTING PROPOSED TOTAL TOTAL EXISTING SF TOTAL PROPOSED SF TOTAL SF **NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ FIXTURES Indicate number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain. MECHANICAL Value of Mechanical Work$ (A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION) AIR HANDLING UNITS EVAPORATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES BBQS FANS GAS WATER HEATERS MISC(Describe) BOILERS FIREPLACE INSERTS HOODS(commrrcmq COMPRESSORS FURNACES RANGES DUCTS GAS LOG SETS REFRIG.SYSTEMS PLUMBING BATHTUBS(or Tub/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe) DISHWASHERS RAINWATER SYST VACUUM BREAKERS DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Tone) ELECTRIC WATER HEATERS SINKS WASHING MACHINES HOSE BIBBS SUMPS SIGNATURE 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 ' , including its officers and employees, upon the accuracy of the information supplied to the city as a part of this licatio SIGNATURE: DATE Property Owner and/or Authorized Agent FOR OFFICE USE ONLY ❑NEW o ADDITION ❑ALTERATION o REPAIR ❑TENANT IMPROVEMENT BUILDING SHELL ONLY? ❑YES o NO BASIC PLAN? ❑YES D NO ZONING DESIGNATION CHANGE OF USE? o YES o NO NEW ADDRESS REQUIRED? ❑YES ❑NO UP/SEPA/SU? ❑YES ❑NO PLATTED LOT? ❑YES ❑NO DEMO PERMIT REQUIRED? o YES o NO Bulletin#100—January 1,2008 Page 2 of 4 k\Handouts\Permit Application