17-104996 ( r3 C 6 3 ' /4
•
PERMIT APPLICATION
CITY OF
Federal Way PERMIT CENTER+33325 8th Avenue South+Federal Way,WA 98003-6325
253-835-2607 + FAX 253-835-2609+permitcentex®cityoffederalway.com
PERMIT NUMBER_j_ P7- — .(. _ ._y J - i...L� TARGET DATE
SITE ADDRESS 000— C & TI`T L N, .S lI 5cqsQ�% , • •
PROJECT VALUATION ZONING ASSESSOR'S TAR/PARCEL•
$ 5 t 12. .'- R--i7,00 4 t n A. - a S2 ? +
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLmON 0 ENGINEERING 0 FIRE PREVENTION
NAME OF PROJECT h/`( Com` R L ik -I✓ Ai&j-t i.,A-R )
PROJECT DESCRIPTION I (0 go tat c OTtP.La I �
S� //--6l �,W"rr
Detailed description of work to po U I-tQ tTl0 t1 �L bR>R lm 4-ki pt& •&3
be included on this permit only ' I.11' , t GE\ 1 -A •
NAME PRIMARY NE
MiKROC.. LAik14141-Acta LLC 2.6 3-I044 € 147
PROPERTY OWNER MAILING AD'L 11
e 1 N QL 42*
1 W XCAtLrRELI
ZIP
C�€1,1,RAL WA`( AA,_ Q$02.3 6cOttccAsAr,14Cr
1a-xu5 ' U IO 1 U &. PROEM 5aill6
MAILING ADDRESS
CONTRACTOR 0/444 # A3\Nti., u-�' 1t`�'bl�xUS
Orly STATE ZIP FAX STUD.°,SWM
WA STATE CONTRACTOR'S LICENSE• EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE I
HEyo6sT 11,301 Kea 1 /va / Iq
PRIMARY PHONE
NAMZ-V . 4y7 ' t2to tt46 5 kittE
APPLICANT. 5
C5 t Pk5 'iov&.3 E-MAIL ADDRESS V
CITY STATE ZIP FAX
NAME *p `' PRIMARY PHONE
PROJECT CONTACT t1� ``f'G ��-f'{ lAput{
(The individual to receive and MAI.DN AD.DR�,E,SIS �v E-MAIL�1 ��AA �/
respond to all correspondence � � u�' pc'? PA J N'y
concerning this application) CITY STATE SIP FAX
NAME
PROJECT FINANCINGyk OWNER FINANCED
When value is$5,000 or more RARING ADDRESS,CITY,STATE,ZIP PRONE
(eCW 19.27095/
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner.I certgy 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, stats, or federal laws regulating
construction or environmental lams.
/further agree to hold harmless the City of Federal Wag as to any claim(including costs,expenses,and attorneys'fees incurred in
theity,
only investigation
and*fens*claimr �offtthe of the city,which may be made including its officers and empincluding the loyees, upoandn the aacccu�racy the the
information supplied to the city as a part of this , •4. ,
�I• I in SIGNATURE: Upi/it 1 ►�l/L ' DATE `D l lU
PRINT NAME:
Bulletin#100—January 29,2016 Page 1 of 2 k:Uiandouts\Permit Application
7: -
8 ,3 „s,„
VALUE OF'MECHANICAL WORK
MECHANICAL PERMIT $
Indicate how rnny 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 Icammer iaa
BOILERS FURNACES HOT WATER TANKS(Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
A`"E orPL"Il/YV TEI.,.WORKPLUMBING PERMIT VV
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(Kitchen einiiyl WATER HEATERS(Electric)
HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS
N o LP P'Jf1-4 LAK RAN/ $
EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM?
%Ixt`D 0/0 Q' r q(„ q e2F 0 Yes_X No ❑Yes X No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
FIRST FLOOR(or Mobile Home)
[� I 7 x x
'�'��y�!�YE!�'.CONs i Oa
.4VVYRYl.'l ,... .. •`K . 3a-_., .. s. �;y"... -i'�s'Ysi+.ai ,z ._ .. _ ... r.. n... r .+r •o-G K k G,.ra+ri+ ___
COVERED ENTRY
_ � tg
PECKr <y Z
` ..,,..r-...a:.,:.,i;cal- .n..a..:a '.:. v,T.• r�::� �i_.k.,�.�x :3".,'� T ..?3S" .
GARAGE 0 CARPORT 0
` �` d' ..... t¢cxa tr,• ( k`ce A F c .1r. y
O,TH•ERa •
1, tvrt r'' A,t£ yl.� {.. �y ^ X
Area Totals EXISTING PROPOSED TOTAL
ESTIMATED SELLING PRICE$ I #OF BEDROOMS
COMMERCIAL—NEW/ADDITION
AREA DESCRIPTION Area Occupancy Group(s) Construction #of Additional Information
Square Feet Type Stories
'i .4r5, t rkAg::' a, "� a r i rt 1 ` i t5 -.a, h r,Fy"M s .m C �'e. '' -x a• _'>,,. 1
., 91xL.• a ars- ,sr4•g:; _ _.3.;,.. -'. �..��r.,,..sY.
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
_
Area in ..... . .. .� . ConstructionAREA DESCRIPTION Occupancy Group(s) <#of
•
Additional Info
rmai t.,ioJ#nSquare Feet Type Stories
5I �Y* » c„.10__. . ' � ?
an"
.• • •
TENANT AREA ONLY
$"+t f >;t it n i y. ...r
PROJEC}I RDA ONLY r z�• }
• .._ �`� - - `in .z ,. •.!.`Sine fi`Sti�..='s,_..
a :�tic
Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application