07-101878 40 • 41
City of Federal Way Demolition Perm#•• 07-101878-00-0 E
Community Development Services
1
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax (253)835-2609 Inspection Request Line: (253)835-3050
Project Name: LBA REALTY
Project Address: 33405 8TH AVE S Parcel Number: 926500 0060
Project Description: "Soft" interior demolition throughout building for future tenant improvement projects.
Owner Applicant Contractor
LBA REALTY FOUSHEE&ASSOCIATES FOUSHEE&ASSOCIATES
660 SW 39TH ST SUITE 255 PO BOX 3767 FOUSHAC158OD(8/12/07)
RENTON WA 98055 BELLEVUE WA 98009 PO BOX 3767
BELLEVUE WA 98009
Additional Permit Information
PERMIT EXPIRES Wednesday, April 8, 2009
Permit Issued on Monday, April 9, 2007
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
and the City ;if Federal Way.
Owner or agent f -dlt?% = Date: „
411/ r •
arroF RECEIVED ?&I
07--- 1_01 :. . Z
Federal Way PERMIT C/
COMMUNITY DEVELOPMENT SERVICES t DR 0 9 2 0 SF MF CO ME EL P �E FP
33325 D AVENUELWASOUTH•PO BOX 9718 �7P P LI CATI O N
FEDERAL WAY,FAX
98063-9718-t8O / /
253-835-2607•FAX 253-835-7B0 fty OF F QE A _............,)
wunacihto((ederalu:au.cont 9 1' n/'1 WeY
kMLDNN c*
The following is required information 2 an incomplete application will not be accep ,•. Please print legibly(in ink)or type.
2U • PROPERTY INFORMATION
SITE ADDRESS_ •)J /Q c 0�� Air: - C'-t/1,1 ) re0 ee4l (. th l.,i l 9EOg3 SUITE/UNIT#
ASSESSOR'S TAX/PARCEL# 9 A (e n5 d - O O 6 0LOT SIZE(sfi
LEGAL DESCRIPTION(e.g.Acme Estates,Lot 1) Ar/ ((6-etA S1i Pe'f
(Attach separate page for lengthy legal description)
• PROJECT INFORMATION
TYPE OF PERMIT 0 BUILDING 0 PLUMBING 0 MECHANICAL
DEMOLITION 0 ELECTRICAL 0 ENGINEERING 0 FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION(Provide detailed description of work included on this permit only)
&h - S u e?cre'-1 rw tee it i2 e e,Nlo j•, r t
PROJECT NAME(Name of Business or Owner Last Name) . /✓ / " ,,r• /
/�
I
• PEOPLE INFORMATION
PROPERTY NAME l, PRIMARY PHONE
OWNER L1EP 4I lz/ ('/25),Vn -d 2 loo
MAILING ADDRESS II Crrv,STATE,ZIP E-MAIL ADDRESS
( o Si") 39d St. ..te X55 'Ptwlbn , w.4 gico5-5
CONTRACTOR COMPANY NAME APP.CANT NAME OFFICE PHONE
) .4rP 6 Pe C1Vua (725) 7
c, -/0O°
MAILING 1 CITY,
CELL PHONE
3)G,o -1051 /due SE telt-04r, t,)4 41A-cos- (9,5- ) 9(// -.) cS
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
Q.-o( - 1OJI94S- oc- g1. 42/s//0o07 ( 9.25)39 - ,)3&
CONTRACTOR'S REGISTRATION NUMBER EXPIRATION DATE E-MAIL ADDRESS
Tttq�u� L/ rOci Wpe/6S'O 6 OFs Jit j ?oo7 3s'of'7 i&iee,Cain
APPLICANT COMPANY N
APPLICANT NAME OFFICE PHONE
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
( ) -
RELATIONSHIP TO PROJECT FAX NUMBER
0 Architect ❑Tenant o Agent o Other ( ) -
PROJECT ' NAME^ PRIMARY PHONEj `/ E-MAIL ADDRESS /
CONTACT JCAvk bo1ewee 01,25 /
) 7b - /OGcy j /Ctee' e-Avsber.reins
LENDER NAME Per RCW 19.27.095:
Lender information is required if project value exceeds$5,000
MAILING ADDRESS CITY.STATE,ZIP PHONE
( ) -
• DETAILED BUILDING INFORMATION
EXISTING USE PROPOSED USE
EXISTING ASSESSED/APPRAISED VALUE$ VAL r •F PROPOSED WORK $
SPRINKLERED BUILDING? o YES 0 NO FIRE S • • _ - ON SYSTEM PROPOSED/REQUIRED? 0 YES 0 NO
WATER SERVICE PROVIDER o LAKEHAVEN ❑ HIG•' I E ■ • • OMA 0 PRIVATE(WELL)
SEWER SERVICE PROVIDER o LAKEHAVEN • -I GHLINE ❑ PRIVAT• = C)
MI PROJECT FLOOR AREAS
AREA DESCRIPTION EXISTING PROPOSED TOTAL
SQ.FT. SQ.FT. SQ.FT.
BASEMENT
FIRST
SECOND
THIRD
ADDITIONAL FLOORS(DESCRIBE)
DECK(0 COVERED OR • . COVERED?)
GARAGE 0 CARPORT 0
EXISTING PROPOSED TOTAL AL SEBTTNG SF TOTAL PROPOSED SF TOTAL SF
NUMBER OF FLOORS
**NEW HOMES ONLY** NUMBER OF BEDRO S S MATED SELLING PRICE $
• FIXTURES
Indicate number of each type offixture fixture to be installed or r *: ed as part of this project. Do not inclurly existing fixtures to remain.
MECHANICAL
Value of Mechanical Work$ (A COPY' BID OR ESTI ► MUST BE INCLUDED WITH APPLICATION)
AIR HANDLING UNITS EV :•RATIVE COOLERS GAS PIPE OUTLETS WOODSTOVES
BBQS F 'S .=WATER HEATERS MISC(Describe)
BOILERS REPLACE INSERTS HO ` (Commercial
COMPRESSORS FURNACES RANGES
DUCTS GAS LOG SIcIS REFRIG.SYST
PLUMBING
BATHTUBS(orTLb/Shower Combo) LAVS(Bathroom Sinks) URINALS MISC(Describe)
DISHWASHERS RAINWATER SYST VACUUM BREAKERS
DRINKING FOUNTAINS SHOWERS WATER CLOSETS(Toilet)
ELECTRIC WATER HEA' RS SINKS WASHING MACHINES
HOSE BIBBS SUMPS
SIGNATURE
I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and further,that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. 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 of Federal Way,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.
NAME/TITLE %iiatC'
rPo/ ELver DATE(ntl
RELATIONSHIP TO PROJECT ❑ Owner ❑Agent ❑ Contractor ❑Architect 0 Other
FOR OFFICE USE ONLY
❑NEW a ADDITION ❑ALTERATION o REPAIR ❑TENANT IMPROVEMENT
BUILDING SHELL ONLY? o YES o NO BASIC PLAN? o YES o NO
ZONING DESIGNATION CHANGE OF USE? o YES o NO
NEW ADDRESS REQUIRED? a YES a NO UP/SEPA/SU? o YES o NO
PLATTED LOT? a YES a NO DEMO PERMIT REQUIRED? o YES o NO
Bulletin#100-April 2,2007 Page 2 of 4 k\Handouts\Permit Application