17-104990 Coosc C.6 d...
AIL PERMIT APPLICATION
CITY OF 411111
Federal Way PERMIT CENTER+33325 8t Avenue South+Federal Way,WA 98003-6325
253-835-2607 +FAX 253-835-2609+permitcentex@cityoffederalway.com
PERMIT NURSER / 7-.2 0 ;/ 9 ,G l/ - s 1-
TARGET DATE
SITE ADDRESS • SUITE/UNIT II
31000 Gm [.1V SW 1 Fi, w x`i . °n o 2.3 14/A
PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL II
$ 4557, oo N-17/oO 4 _a /. t n A. - a S2 2, It-
TYPE OF PERMIT o BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT IA t K, •O R LI1/4•1Ai wit-4-1400
PROJECT DESCRIPTION 1 l0 ROME L O 1tkCa E. 1. Slt 461 -P "
LM
Detailed description of woric to t=o U o Kt1014 OP L1/44 PO& CA MA DR 4 13 1)1,1Z 1i4(
be included on this permit only .ti--K., 5471-17. C__,(5f.
PRIMARY
HONE
MAIniMiKROt. t„&t-E ist411)-ARt LI-C 2.6'3Plog•F)14/
PROPERTY OWNER RESS
504121 T DFL 47\4 W. IAtCA fR-i'-(
SW
� j L WA`s wit,- qt.02.3 6e-DIV trRE`'
NA
1411'1(1)5 ' cu iol WC. PHONE
6
CONTRACTOR MAUMG E. i bA 1 {c,, tiu-e'. 14ebifxUs
CITY STATE ZIP FAX %ON 0I.COM
WA STATE CONTRACTOR'S LICENSE I EXPIRATION DATE FEDERAL WAY BII81NESS LICENSE I
HExvtici 01301 Kb ' '), IV' / ICI
RONE
14U 05 S��to ltG PR 5A t4E
v E-MAIL
APPLICANT. I
CM,5 A , RS MeV&. SAmt,
CITY STATE ZIP FAX
PROJECT CONTACT
NAME/311.-L MCGF�G! PR-V4 PRI>�IAitYl f,
(The individual to receive and ADDRESS �� ��6‘i�\ E-MAIL ��
respond to all correspondence J
concerning this application) CITY STATE ZIP FAX
PROJECT FINANCING NAME A.OWNER-FINANCED
When value is$5,000 or more MAILING ADDRESS,on?,STATE,ZIP PRONE
(RCW 29.27.095)
I certify under penalty of perjury that I am the property owner or authorised 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 authorised 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 the-alt//as a part of ' ' /' j
SIGNATURE: Mi
_ DATE 10 11,b I 1
PRINT RAMIE: vim+l IL- l k
t `-1 ' i kt F1"(�'1
Bulletin#100-January 29,2016 Page 1 of 2 lc\Handouts\Permit Application
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ta,
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VALUE OF MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how any 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 OUTLI:IS OTHER(Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS(commerei.s
BOILERS FURNACES HOT WATER TANKS(GO
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT c:•y 4�rr.G WORK
I.
I $
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 usteen/uulty) WATER HEATERS(Elecin)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N0 Lt .1 P4 N LAt«,RAM $ b4/c
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
t-tooxE-1)1(4-40`o D_I ' ,3 41e 0 Yes,X4 No ❑Yes >( No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
*BASE 7MENT• e.. ;,«, -tet...:4-:.-_,,,,,,, i4,...4:12:-.4,..4.4i+-r .•..�, r:, u4.. `.
r
FIRST FLOOR(or Mobile Home)
�y? cy ;x
t 'iag-i.:. .14 1,... . • '2:sssa .si ' F . .. ,..:,...i' '...1.--,,,..d..,.} w t ...:.M
COVERED ENTRY
D7�ECK r ', .Ty, ,.rw r-t wF� Y, � s -v.... xz* ,:3 .,
GARAGE 0 CARPORT 0
Area Totals EXISTING PROPOSED TOTAL
rwrn : z.+...,,
ESTIMATED SELLING PRICE$ I #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square Feet TiFe
,.. -7,7,.i"--7._ . In. t a Stories
- r te . vx �. ar �' i e ° t,,% ^ -
t x +.�"' ;D�sbf.� 'r., r Ya. ,7,"° 7d+ .>,r�:" '"::,. ...."'''.:.;-4-,<-2;::, f. _ 9.r r�w.ss � ,.'c>{Y ,"' v",'o i /0.,:.r:
.7..,.,4V.,21-'-;..GV.
.
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION Area m Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories ,
xTQ"P�L IF7DINO .-...;i:,:,,,„„.:;,:::;,,•:',,7-,, r L arta ;'•- ! � _ 4,-: I..'y':';',.'"---:-21.' .eS' aar-r T
a �
,1 - .._,«...,:�'K' .<sttk..��x a. asp_ ....zC�..U�#i t=. ,:^�n':„eS<fi:�, _ a.:�, .'s _ 1.44. .
TENANT AREA ONLY
A rw�* r 1
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