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19-105127 RECEIVED CITOF +r�.�-- PERMIT APPLICATION �Y OCT 2 4 2019 PERMIT CENTER+33325 8th Avenue South +Federal Way,WA 98003-6325 Federal Way 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com CITY OF FEDERAL WAY COMMUNITY DEVELOPMENT PERMIT NUMBER I _I _ t O 5 1 Z '1 _ F P TARGET DATE SITE ADDRESS SUITE/UNIT# C:711;OS S 30 � % eC)ea\ W ct1/441 Ps %O61 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# TYPE OF PERMIT D BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING FIRE PREVENTION NAME OF PROJECT W 1l A `1 M^\ (_` t o S c od PROJECT DESCRIPTION 1 Detailed description of work to `� % ' O _N, (' Vk... be included on this permit only R 'w _/�� Ir �� ` NAME PRIMARY PHONE 1-7- e c a� t�� Sc4,oc,`��s),rcck • _ • S a ` • PROPERTY OWNER MAILING AD 3 -MAIL cl-faefa� Z�gQo 3 �bc� ct1i o 31 z . _... NAME �- c " PHONE MAILING�a( � C ori5c vc%tcfil 360— =Slq br ADDRE3 � t 4 V vW� CONTRACTOR 0 ( a ` neeSor matc. CITY STATE_ ZIP� �©g nk R'SLIFAX • � �J� WA STATE CO RA O "ICCENSEERPIRATION DATE FEDERAL WAY BUSINESS LICENSE# V'O lazt4Pcc RA OX 406V Wk /1� NAME—Nr01 '-V' - C-0%&- \11V C \�(/S \ PRIMARY PHONE APPLICANT- M .jrin T OX X)IAC E-MAIL CITYO XUl�c)tet STATE ZIP� 50 FAX NAM Qr ceLt 0.i-Ae (&„� . .Q s-7) - '' 1� 0 MAI� DR &individual receive and respond to all correspondence � d� kk O1 & .ce.\\\Q- ver tC-c ''1 concerning this application) CITY STATE ZIP FAX 01`kirV1.. wSA CkgSaV NAME PROJECT FINANCING OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP PHONE (RCW 19.27.095) 6 , • 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 applicatio . SIGNATURE: , JA DATE 16 -2M . l� � PRINT NAME:J� a f l�4e -tot.- - 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 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 t SIN1‹8(KitchfntUtil y) • WATER HATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFOkMATION , •• ., ' r CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR - VALUE OF EXISTING IMPROVEMENTS $ • EXISTING/PREVIOUS USE LOT SIZE JIn Squaie Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? t ' . • ' • .%, D Ysi❑ -No • es ❑ No • a r •5 r..� ,•ff, tc.. • c RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTIPIG PROPOSED •TOTAL FOR OFFICE USE flit'tLiOOR f Moitb Hom. e) F .- . . . r .c� 4#M � 4J �,,Y1� 9,„.,:„,.;„:,-,%:::-.."7-e' "i,, rf U?,ark�..,r,may. . '.r " eli4 , ^� . _ � —_._.................._......_._...._...-__..._—_._--_—_..._....__..__......—___..... .__.__._....__._._...__ COVERED ENTRY ' •I ' , ' E • r D � r .. ,».*..,.. 4q„"f.l,,. .ua Mt-6+2r��aN� F...«b�. wz+> K '- d `t v. smv..n ,.fes,_ 7, I7 .—__._ __.._.........__._._.......__.... ..._.............._..__--___.___ ._'__ GARAGE ❑ CARPORT D de, ;_ ..., ' HER(drl � ; Oscb ) .. « EXISTING. • PROPOSED , , TOTAI 'Areacotais ......._..............................__.............—_......_..._..___._._.._._..__»_...__..___..................._._.._...__........_ u. > __ it ,�. _ `• ESTIMATED SELLING PRICE$ I #OF BEDROOMS" ' • r . COMMERCIAL-NEW/ADDITION AREA DESCRIPTION • Area in Occupancy Group(s) Construction #of Additional Information Square FeetType Stories i777.7777.7 m i> INs a,14 4 r n .d- a vt„ a .fsn g Sn j m P:» s 2 ae' r4xii4i4 %n .r 1n. .„ I;777777.:,fl.!” 4, .4,4,14,...,44; 4: , ADDITION COMMERCIAL-REMODEL/TENANT IMPROVEMENTS Area in Construction #of AREA DESCRIPTION Occupancy Group(s) Additional Information Square FeetType Stories Ll4 „ b � sw r` � 4 � u ¢te� f' ' r ,.. �3 �� a x sv x V2OTArB Iro` m . >. -:�,n..�. r..a..r , , .,,< ;r.- ,,,.; .:..r � . , xr,; :.44x ''''. ."-7.7"4,37.E » o ,. ?. 0 ?7, ITENANT AREA ONLY ll PROJECT AREA 4 " .,,, , .r Bulletin#100-January 29,2016 Page 2 of 2 k:\I-Iandouts\Permit Application