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17-103325
CITY OF �,! PERMIT APPLICATION Federal Way PERMIT CENTER+33325 8Th Avenue SoyL1; �.jyA98003-6325 253-835-2607+FAX 253-835-2609+oc ii �U,ay.com PERMIT NUMBER 10 93 2 5 Co J U L 1 1 2017 - - - - - - TARGET DATE CITY OF FEDERAL WAY SITE ADDRESS CCUs TY DEVELOPMENT #LOPMENT 501 South 336th Street 98003 1 l D PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL I $ 23,947.00 OP 9 2 6 4 8 0 - 0 2 4 0 TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL rgt DEMOLITION ❑ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT NKC Federal Way West- Soft Demolition PROJECT DESCRIPTION Removal of all interior previous tenant built assemblies to facilitate a new Detailed description of work to tenant improvement project by NKC under a separate permit. - See be included on this permit only attached D2.01 - Level 1 Soft Demo Plan by Salus Architecture. NAME PRIMARY PHONE PROPERTY OWNERo s,YI: (il Y' l- `aza.2kS- oc'.i ci 4 2 5- asci- a-a 31 MAILING ADDRESS E-MAIL i?O --)O)( X ? jtrui,cer-soroceniv es.curl CITY , e Il-e.utd— t,6P- Lr^rx_ Dc yA NAME Aldrich +Associates PHONE -483-1313 CONTRACTOR MAILING ADDRESS 810 240th St SE E-MAILbn@aldrich-assoc.com CITY Bothell WA98021 TE ZIP FAX 425-486-1018 WA STATE CONTRACTOR'S LICENSE/ EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE I 600384678 _ 08 i 31 /17 20.13.105569.00.BL NAME Northwest Kidney Centers PRIMARY 206 --720-3765 APPLICANT MAILING ADDRESS ZMAI, 700 Broadway randy.thompson©nwkidney.org CITY Seattle STATE ZIP FAX WA 98122 NAME Salus Architecture PRIMARY PHONE PROJECT CONTACT 206-652-0722 (The individual to receive and mmuNG 140 3rd Ave, Suite 200 E-MAILresalandi@salus.archi respond to all correspondence concerning this application) CITY Seattle WA XFAX 98101 PROJECT FINANCING NAME lir OWNER-FINANCED When ualue is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27095) 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,expensesand 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 a part of this application. //-- ` SIGNATU e Q / DATE t-��t�OCL)n PRINT NAME: 1 -ril ,f1s ¢.%•zidl R✓ 66--ru-e pry x9-e- Bulletin#100-January 29,2016 Page 1 of 2 k:Wandouts\Permit Application