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19-104636 RECEIVED CITY OF SEP 2 6 2019 PERMIT APPLICATION Federal WayCITY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325 253-835-2607+FAX 253-835-2609+pernutcenterAcitvofederalwav.com COMMUNITY DEVELOPMENT / 0 LI (3 Co - P P PERMIT NUMBER / q_ - ' " L - .�.- TARGET DATE SITE ADDRESS SUITE/UNIT# 2.\22. 5. 31'-x'1 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL• $185©U-00 o 9 Z i o y - 9 v 53 TYPE OF PERMIT ❑BUILDING ❑PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING KFIRE PREVENTION NAME OF PROJECT a\ )'l , \\\1 kA.D15 PROJECT DESCRIPTION Detailed description of work to Q\T 'i�rAS be included on this permit only 'e`O c - -e ( ) hecas P l PROPERTY OWNER `✓�� 1..�-# PRIMARY PHONE I(�►Q[.IIfGA E-MAIL Nc;r na-vr-c , lhc- Pt 3 .i j•7C0a 9 XMAIL CONTRACTOR �1/� 2-A PSS`C104.elC YO w CDA1t\1\ Com. Zqt� AX WA STRACTOR'S ATE %, o[I LICENSE 1. EXPIRATION 21 i9-98- Slo DT I NAME PRIMARY PHONE • 5aYY1P_ c ) Ctbr rtar 1-CY' APPLICANT MAILING ADDRESS E-MAIL CITY STATE ZIP FAX PRIMARY PHONE PROJECT CONTACT NA5 1 St1 L e ` 1)2,5' 7 p 1166q (The individual to receive and NAILING ADDRESS V �>FltAtL �^ respond to all correspondence Ll y15+IC e.l^YOWa 1r pCoh'i concerning this application) CITY STATE ZIP FAX NAME PROJECT FINANCING 0 OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) l 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 • them�e city as a part of this application. SIGNATURE: 1]. 44 / dI fi L441Lill !DATE Al'Lf q PRINT NAME: JtS5 Ica Y) > 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(commrrci.') BOILERS FURNACES HOT WATER TANKS(0.) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING 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/shover combo) LAVS(Hand sinks) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)' DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS(Kitchen/utility) WATER HEATERS(Eieetnc) HOSE BIBBS SUMPSWASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS OA PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRIEEI.ER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑Yes❑ No ❑Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL' FOR OFFICE USE f_*'` '�,, _ - •'' " "^ ' ''�°.a'th �" "1.;. - "r!.pi-„ 4 � +w r�. • y .. x... .+�,a Mkt. , t ," a: :'�",'*,�";q:�, - �S,T 5^`•Ea,,;�+_-,-,,,f. --.rr��` PIRST FLOOR(or Mobile Home). ' . ' (` ye Irk j 1 rr --z:',,",,-:: ..'---',....Zi--3•114:4-.4: ,- "���•.�-.! t= "FF. "'.r + '� fi1Y1+111 ' :,. Gam+", �",r.:'";ti','.._:�:ay s `+5',"'r�. YX � � �tb'r!'>. •- W4't'h Y}�`.,'V "- � y A. ,ten COVERED ENTRY • fl:', , ',F-, ,,t,'-,' -'�.. +." W;.,' t'-':'-'44;1 ,:e,y 4„ ,/�" � . .. -, GARAGE 0 CARPORT 0 • ' ^ /.] t `yrf J--[ 3y� - i fl �- ".{;!''j.:,k "_ _YAit��S,! -w i" -•.. "� . ^'v-'a; .. .� O,1,, ,,,,,-..,-,..s-;,:•-,•<' _ vrr5=�w TMINGrROPOSm TOTAL ,, - .- .. .,, Area Totals '�.ka-'-'.Y.l*a."..L i = -A!,t?irt', ` s-'i�'{ :i:`�`�."�..;��}-lsiC�iL'i.viF,.'-y'� ESTIMATED SELLING PRICE$^ #OF BEDROOMS COMMERCIAL—NEW/ADDITION AREA DESCRIPTION Area is Occupancy Groups) Construction #of Additional Information Square }'uare Feet Tyke Stories . y. ,f.-. _ _•q"i - SFA T" _ i _ - ::;:l.'4:"":4,„!:_,-,::-,;','-;• _ -e f:M.- r^ . r: . '4"- ''';'%:::'',-"'" ``-:'-:a,s' _ __ - - -M+ ' :4"•.: ;•_e,E'�'Yi?'•= ,+. �F 5 t. ?L_�.n'::>�,`"''.. fir' _ .� - •,, ADDITION COMMERCIAL—REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area Occupancy GrouPlsl Construction #of Additional Information Snare Feet T1iStories TOtititi*LitiiNr'- -,l+Es ;a� .,-F -,-‘,,,,,f4.17,-,s.:',!--,',,z ,it_',ie -�ii'`'r x:,..c. .. !,,Gi'ti £,r�;t#`=-�:.r�,rs'=�-i�-•-'�`,_'�_s,' `.-�3.•"-_��r.` - .Si '��;.; ",ar„-;�zkr'w=.�'--�:,”-.�s'K==:� '*'�r�:.�i,_,`£Yt�..-.^.i.�,=o- ��.. ,: ii'w sz'�.�r:::�'��:�x =.,.�,. ,‘. , .. ro�r,l_!<•.I�: �..� ,�°;� c:.__>�..t�'fi".�,��:�.-.:=., TENANT AREA ONLY Bulletin#100-January 29,2016 Page 2 of 2 k:\ andouts\Permit Application