01-103533 fiy3
cr.o. CONSTRU•ON PERMIT APPLICATION
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�� FY APPLICATION NUMBER: _ 0 5.S3-
APPLICATION NUMBER: - -
SEP 1 n ?QM APPLICATION NUMBER: - -
**The lM + formation-Please print(in ink)or type**
Please note: Electrical, Fire Prevention Systems and Engineering permits may require a separate application.
■- PROPERTY INFORMATION
SITE ADDRESS: 31070 14th Avenue South ASSESSOR'S TAX/PARCEL #: D g Z I 49 - 106z
LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY):
- • = ■ PROJECT INFORMATION =
TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING El MECHANICAL ❑ DEMOLITION
❑ ELECTRICAL ❑ ENGINEERING® FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description): Instal1221-.22' of 6" D.j. north of SDCVA vault @ SW
corner of new Albertsons bldg. and extend 14' of 6" J.I.% 90° east into bldg, with a 9'.
riser that extends 1' above F.F. Also install ' of 4" D.I. with a ' riser inside the
bldg. and an FDC connection outside the bldg.
PROJECT NAME: Al bertsons's Store # 496
- • PEOPLE INFORMATION . : - - - -
PROPERTY OWNER: NAME• DAYTIME PHONE:
Albertson's Inc. (208 ) 395 - 6450
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
250 E. Park Center Blvd. Boise, 10__837116
CONTRACTOR: NAME: DAYTIME PHONE:
Pacific Rim Construction (425 ) 228 -4858
MAILING ADDRESS(STREET ADDRESS,CITY,STATE,ZIP) EVENING PHONE.
P.O. Box 2670 Renton, WA 98056
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: /� FAX NUMBER:
O_ L L JU i (4."' ) - -
CONTRACTOR'S REGISTRATION NUMBER. EXPIRATION DAT :
(copy of card required) Y
P A C I FRC 1 41 On D 1/ 24 / 2002
APPLICANT: NAME: DAYTIME PHONE:
Joel Holland (206 ) 730 - 8983
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP). EVENING PHONE:
P.O. Box 2670 Renton, WA 98059 ( ) -
RELATIONSHIP TO PROJECT. FAX NUMBER.
❑ ARCHITECT ❑ TENANT [1 OTHER( DESCRIBE): Utility crew (425 ) 228 - 3233
E-MAIL ADDRESS
CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ] APPLICANT ❑ CONTRACTOR
- - ■ DETAILED BUILDING INFORMATION -- - - - --
EXISTING USE: / EXISTING BUILDING ASSESSED/APPRAISED VALUATION $
PROPOSED USE: 6/27Cee S'1or!i PROPOSED VALUATION FOR IMPROVEMENTS: $ Ol't4115-'"
SPRINKLERED BUILDING? ® YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: El YES ❑ NO
WATER SERVICE PROVIDER: I LAKEHAVEN ❑ HIGHLINE El TACOMA ❑ PRIVATE(WELL)
SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE(SEPTIC)
**NEW RESIDENTIAL CONSTRUCTION ONLY**
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 UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S)
BBQ(S)
FAN(S) HOOD(S) WOODSTOVE(S)
)
BOILERS) 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 SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS
DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE 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 of this app'cation.
NAME/TITLE: EJ Schmidt, President DATE: 8-21-01
❑ PROPERTY OWNER ❑ APPLICANT [ CONTRACTOR
FOR OFFICE USE ONLY:
El NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT
CENSUS CODE: LOT SIZE:
ZONING DESIGNATION : BUILDING SHELL ONLY? 0 YES ❑ NO
COMP PLAN DESIGNATION BASIC PLAN? 0 YES ❑ NO
SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO
PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES ❑ NO
__ - -- -.,e.nor.ienrr cro,tree.Zlcif1 F?RCT%nay<nrml.p n FM 97IR•FFDERAL WAY WA 98063-9718•253-661-4000•FAX:253-661-4129