19-105388 CITY OF RECEIVED PERMIT APPLICATION
Federal Way NOV 0 8 2019 PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607+FAX 253-835-2609 +permitcente6v,cityoffederalway.com
CITY OF FEDERAL WAY
COMMUNITY DEVELOPMENT
PERMIT NUMBER —�j y�)r 1 -
Fp�� J !/G_ TARGET DATE
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SITE ADDRESS SUITE/UNIT#
33320 9th Ave. S.
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL#
$ 23,516.44 9 2 6 5 0 1 - 0 0 4 5
TYPE OF PERMIT ❑ BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING NI FIRE PREVENTION
NAME OF PROJECT City on a Hill Church
Red Hawk Fire Protection to connect to existing 8" Lakehaven City Main and
PROJECT DESCRIPTION provide a single 4" fire service line with wall FDC
Detailed description of work to g
be included on this permit only
NAME PRIMARY PHONE
City on a Hill Church
PROPERTY OWNER MAILING ADDRESS E-MAIL
33320 9th Ave. S.
CITY STATE ZIP
Federal Way WA 98003
NAME PHONE
Red Hawk Fire Protection 253-840-9900
MAILING ADDRESS E-MAIL
CONTRACTOR 801 Valley Ave NW - Suite D insp-permit@redhawkfp.com
CITY STATE ZIP FAX
Puyallup WA 98371
WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE#
REDHAHF901QP 12/j31/19/ 20-11-103793--BL
NAME PRIMARY PHONE
Same as Contractor
APPLICANT MAILING ADDRESS E-MAIL
CITY STATE ZIP FAX
NAME PRIMARY PHONE
PROJECT CONTACT Emily Gouin 253-840-9900
(The individual to receive and MAILING ADDRESS E-MAIL
respond to all correspondence 801 Valley Ave NW - Suite D emilyg@redhawkfp.com
concerning this application) CITY STATE ZIP FAX
Puyallup WA 98371
NAME
PROJECT FINANCING N/A NI 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 of this application q l fC�
SIGNATURE: �/ �\ `` DATE 1 ` l (1 1
PRINT NAME: w (-1t7 l� � 4;1 �'ri C'("-j- VI/
Bulletin#100–January 29,2016 Page 1 of 2 k:\Handouts\Permit Application
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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 TANKS)Gas)
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/Shower Combo) LAVS)Hand Sinks) TOILETS WATER PIPING
DISHWASHERS RAINWATER SYSTEMS URINALS OTHER(Describe)
DRAINS SHOWERS VACUUM BREAKERS
DRINKING FOUNTAINS SINKS)Kitchen/Utility) WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
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?
❑Yes ❑ No ❑Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
BASEMENT
FIRST FLOOR(or Mobile Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER(describe)
EXISTING PROPOSED TOTAL ..
Area Totals
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE$ #OF BEDROOMS
COMMERCIAL-NEW/ADDITION
AREA DESCRIPTION
Area in Occupancy Group(s) Construction #of Additional Information
Square FeetType Stories
NEW BUILDING
ADDITION
COMMERCIAL-REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION `ream Occupancy Group(s) Construction #of Additional Information
Square FeetType Stories
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application