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17-103938 ,,,,A, : /,,,,,, ...' y=,'I'''' ',# PEERMIT APPLICATION CITY OF Federal Way PERMIT CE enue South + Federal Way,WA 98003-6325 253-835 EL/5-2609 + pertnitcenter@cityoffederalway.com 3 1152017 G� I j PERMIT NUMBER ' �9 `/ V ` 9 7--- — — —GilPfOF FEDERATWir DATE COMMUNrTY DEVELOPMENT SITE ADDRESS SUITE/UNIT# ( SD cvi CINV1 POS 7(Z • PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL M Q / TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION NAME OF PROJECT Com.,-S -1/CQ 0ATI c ( -'EL e. j r,,s Lc 133 - - - -s Cam '.--t-i5 PROJECT DESCRIPTION Detailed description of work to MgSkL lt3' €e)Leif\_ socA S be included on this permit only — - - -- - NAME y PRIMARY PHONE Yeti►&\ CAk3 J I c Ca-.�-rt-,t- PROPERTY OWNER MAILING ADDRESS E-MAIL tCITY (0c0 C)LS 02- CITY cV DeT W STATE ZI7GAP �^ U-I.;-S NAME� 1.-�` L- ,►c!1 s--- c ------- PHONE 4.L--. ZK MAILING ADDRESS ,// E-MAIL CONTRACTOR 4l �'g `x CITY C..7��l `L ` STAT1, ZIP ^2� FAX WA STATE CONTRACTOR'S LICENSE# [V-V��, EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# Wj*q‘© So / --/ NAME PRIMARY PHONE --(LLL. (L0't2_ -- 6c3s(,Z(4--G$ APPLICANT MAILIN A�DD�RfESS „ _^ E-MAIIf `� l �(9, 42-U,L,Q G-,e.S s,,LYr(l 1 NC, CO CITY \VX-ikk Inv� STATE Z9.n 7 FAX 7743 - - NAMEr-- - --�--J PRIMARY PHONE ---� � PROJECT CONTACT L ,Q vLc�Z 'S b -ZZF-q' � - r,35 (The individual to receive and MSL °eDDARiss e_ E-MAIL respond to all correspondence �1� concerning this application) CI STATE ZIP FAX 'mss 1k ' �–�-- c ldn RS 22� - - - S NAME • PROJECT FINANCING AgSe 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 a part o this application.;,-,) , -y SIGNATURE: DATE r( J i l PRINT NAME: V t L- 7CS_2 Bulletin#100-January 29,2016 Page 1 of 2 k:\Handouts\Permit Application VALUE OF MECHANICAL WORK MECHANICAL 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. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER(Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS(Commercial( BOILERS FURNACES HOT WATER TA : (Gas( COMPRESSORS GAS LOG SETS REFRIG ON SYST DUCTING •GAS PIPING W•: STOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ Indicate how many of each type offixture to be in : ed or relocated as part of this project.Do not include existing fixtures to remain. BATHTUBS(or Tub/Shower Combo) - ' (Hand Smits) TOILETS WATER PIPING nISHWASHF.RS RAINWATER SYSTEMS URINAT S OTT-IFR pper.rihol DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAIN SINKS(Kitchen/Utilay) WATER HEATERS(Elechrr) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES I GENERAL INFORMATION CRITICAL AREAS ONO PROPERTY? WATER PURVEY SEWER PUR OR VALUE OF EXISTING IMPROVEMENTS 5:'r $ EXISTING/PREVIOUS USELOT SIZE(In Square Feet) EXISTING FIRE SPRINKLE YSTEM? PROPOSED FIRE SUPPRESSIO YSTEM? C/a/It yr? D'1 al mfg -�`, ❑ Yes o ❑ Yes L#'No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR p,u('.". / DECK GARAGE ❑ CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals **NEW HOMES ONLY** .. ESTIMATED SELLING PRICE$ #OF BEDROOMS COMMERCIAL-NEW/ADDITION AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information Square FeetType Stories NEW BUILDING ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area in AREA DESCRIPTION Occupancy Group(a) Construction #of Additional Information Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application