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19-104101 RECEIVED ,„,,, _A.CITY OF AUG 26 2019 PERMIT APPLICATION CITY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+-Federal Way,WA 98003-6325 Federal Way COMMUNITY DEVELOPMENT 253-835-2607 +FAX 253-835-2609+permitcenter©cityoffederalway.com PERMIT NUMBER 19 _. Q I 0 / _ PP TARGET .M/A"...' • DATE SITE ADDRESS ll SUITE/UNIT# Z( I t 0 k.6A- -Ave .S\ \I PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ (C) (..2 l.JDM ce C. Ct A__ 0 0 - O C) 02 O TYPE OF PERMIT ❑BUILDING ❑PLUMBING ❑MECHANICAL 0 DEMOLITION ❑ENGINEERING flSi.FIRE PREVENTION NAME OF PROJECT artid PROJECT DESCRIPTION -irP, c`\arm I CMACii Cil 'CVWI O6 Detailed description of work to be included on this permit only • ---- ^ --- PRIMARY �PHONE PROPERTY OWNER � J� fl‘(?)VV( LJ AN (JM� 41Q)-1 ?55 • - IQ TY 9AC1MS0Clice tIm r/jAME PHONE C WC ACX A. LI�.r ./7- � klIti o)lifig q-(40 MAILING • �( ` ADDRESS L ( /'� CONTRACTOR \ 1 - \* kie • `� "i""�ipklUA•��RJ CITY STATE IP FAX ,,, ` .0 \(NA pg\33 C3 TA(eXAc otcur .0 WA STATE CONTRACTOR'S LICENSE Y EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE S NAME PRIMARY PHONE \C Q e. YCVL/\TkC�Uv0v� O�Q�lQ -' z '(Q APPLICANT. MAILINGADDRE S pcve, .5 AIL CITY STATE ZIP FAX '` f*V�� \ \ A�SL� rd PHONE PRIMARY (may P�rI,�Y�+ pin PROJECT CONTACT �N�`�[ SCC t C�V� � - C�(��V�D' "J � (The individual to receive and MAILING ADDRESS• I� lJAn, k.-11-6respond to all correspondence \ST P ':/ A Off1p1 Civ vG. concerning this application) CITY `STATE VP_ FAX (• NAME PROJECT FINANCING ❑ OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 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 city, including its officers and employees, upon the accuracy of the information supplied to the city as apart of this application. SIGNATURE: Ij�b. u DATE 4 1 D PRINT NAME: _ re,Xf • b r A- We V iv` Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application • • VALUE OP MECHANICAL WORK MECHANICAL PERMIT • $ Indicate how many of each type offixture to be installed or relocated as part of this project.Do not include existing fixtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(co...14 BOILERS FURNACES HOT WATER TANKS(G.) , COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE oF PRIA4J3ING WORK PLUMBING PERMIT Indicate how many of each type of fixture to be installed or relocated as part of this project.Do not include existing fixtures to remain. BATHTUBS(or Tub/Shower Combo) LAVS Sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS . ' OTHER(Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/Utility) WATER HEATERS(131.tric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FDCTORES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE(In Square Feet( EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? 0 Yes 0 No 0 Yes 0 No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING 'PROPOSED TOTAL FOR OFFICE USE _ FIRST FLOOR(or Mobile Home) COVERED ENTRY ' GARAGE 0 CARPORT 0 __ /*An, •;„; 5,,rf-'t 03,ST EXISTING PROPOSED' TOTAL Area Totals -72J. ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL—Ngw/ADDrrioN Area in Construction #Aof REA DESCRIPTION Square Feet Occupancy Group(s) Additional Information Tyye Stories c f- "L ADDITION • COMMERCIAL—REMODEL/TENANT IMPROVEMENTS Area in Construction #of AREA DESCRIPTION Square Occupancy Group(a) Additional Information Feet Type Stories • ,- TENANT AREA ONLY PNOJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\I-landouts\Pennit Application