02-101650 — REIVED
en of = CONSTRUCTION PERMIT APPLICATION
Eris-L_ APR 1 9 2002
APPLICATION NUMBER: D2 - �� / � �� - OU �
• CITY OF FEDERAL WAY
BUILDING DEPT. APPLICATION NUMBER:
APPLICATION NUMBER:
**The following is required information-Please print(in ink)or type**
Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application.
• PROPERTY INFORMATION 2 /
SITE ADDRESS: 33702 2.t'A v S•41/.. ASSESSOR'S TAX/PARCEL#:q3 O l (2 6) - zD C/D
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
• PROJECT INFORMATION
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING VFIRE PREVENTION SYSTEM DE7
PROJECT DESCRIPTION (Provide detailed description): zvoil( pox/6. J /�U S �' , ooftTie 4j
of 46 ekes 1/i/G via/Arta' i -4 7 1 o yak-pLoPi SPA-Gm/e-- P IM -l3
t/TV 0 F FFDEM L 4v4 Y /?r✓ )viRg-tiles/[. keLoC411 .t/ 6F sp,e/AAekI� QS
$ PVC TO NE U 41411-CS 8 UI r ir5X4DDO,.
PROJECT NAME: F,L,IJncrat
• PEOPLE INFORMATION
OPERTY OWNER: NAME: DAYTIME PHONE:
ale)
,IEY (5-03) 232 -k894-
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
3BO D S•E.
22-11-' A Poie7L4/D , of(C-G-n,/ 9'720?-
CONTRACTOR:
CONTRACTOR: NAME: DAYTIME PHONE:
Go Cu) mks P4)7E-me / .z-A16_ (.17 -) a7
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
I0 5 o 1/7 TM PL. i/ krAKL/4�iD, wA qgo 33 (4 -) 'Z7 -96stt
CITY FEDERAL WAY BUSINESS LICEN E ER: FAX NUMBER:
o/% zp�z - f= Z 0 - o 1 r o i g - �' 9 (4ZS)/Z 7 - 7f74
C NTRACTOR'S REGISTRATION NUMBER: `' k`� EXPIRATION DATE:
(copy of card required) C 0 5 CO EE i 1 O N oi l // l zoo,
APPLICANT: NAME: DAYTIME PHONE:
/144-TT JOSS (425) F�27 -%51-
MAILING ADDRESS(STREET ADDR 5;CITY,STAT ,ZIP): EVENING PHONE:
/09/0 //77), fL /f/b" Kg IAAO , 4(/f I1"v33 (4Z5 ) �17 - ,4g4-
RELATIONSHIP TO PROJECT: p FAX NUMBER:
El ARCHITECT o TENANT 4/OTHER(DESCRIBE): 60&7 ,e (4j5 ) O�/
Z7 - 74.7f-
E-MAIL
7 79E-MAIL ADDRESS:
CONTACT PERSON FOR THIS PROJECT: o PROPERTY OWNER VAPPLICANT [CONTRACTOR Ms)on-e5fiscal Irc.com
• DETAILED BUILDING INFORMATION
EXISTING USE: /RST 1L EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: I(EI TIT LE, PROPOSED VALUATION FOR IMPROVEMENTS: $ CP, / SOIllk
INKLERED BUILDING? 3 YES o NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: y'YES ❑ NO
WATER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE ❑ TACOMA o PRIVATE(WELL)
SEWER SERVICE PROVIDER: o LAKEHAVEN o HIGHLINE o PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
•
•
1Au
• • •
•
NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $
• PROJECT 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 EVAPORATIVE GAS LOG(S) REFRIG.SYSTEM(S)
UNIT(S) COOLER(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 ❑ GAS
PLUMBING
BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S)
DISHWASHER(S) RAIN WATER VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
SYS.
DRINKING SHOWER(S) WASH MACHINE
FOUNTAIN(S) OUTLET
GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC. ( )
INTERCEPTOR(S) _ SUMP(S)
• DISCLAIMER/SIGNATURE BLOCK
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 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 of
Federal Way,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 a part o his application. p
NAME/TITLE: F' �_ DATE: # /6
❑ PROPERTY OWNER VAPPLICANT 5/4 NTRACTOR
FOR OFFICE USE ONLY:
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
• ZONING DESIGNATION : BUILDING SHELL ONLY? ❑ YES o NO
COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES o NO CHANGE OF USE? o YES ❑ NO