Loading...
01-104751 CONSTRUCT I ION PERMIT APPLICATION uV CI lia �[J APPLICATION NUMBER: Q1 - Q "� - jf� /t1/41r(A/ APPLICATION NUMBER: - 1 C 14 ®© APPLICATION NUMBER: __ - - __ - - **The f.11l. i iWe m l Ar - ation—Please print(in ink)or type** :LADING DEPT. Please •te: Electrical, ' • Prevention Systems and Engineering permits may require a separate application. "' • PROPERTY INFORMATION _-' SITE ADDRESS: 4 C15- 6014. Ave- 5 ASSESSOR'S TAX/PARCEL#: 752 4- l- _ - O02 000 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): f ss' .s . ■ :PROTECT INFORMATION _ - TYPE OF PROJECT(This application): ❑ BUILDING PLUMBING ❑ MECHANICAL ❑ DEMOLITION ' ❑ ELECTRICAL ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM PROJECT DESCR TION(Provide detailed description): (ndeer9 roc. vl '• m< `tVIII a/ 5 - _ Da . P WI i • ro rel (,�? i vJ o aS{e. V/% ai+n ' :Alr 4mbula, J 2t vIgTOn PROJECT NAME: - K' , „coo / Lam/ i Ai - / / id �_ / ' C •='PEOPLE INFORMATION PROPERTY OWNER: NAME; / C 5 4/0"r:9 /J (A E PHONE: - MAILING ADDRESSES (STREET ADD` ;CITY, ATTEZI �C// "34 cif Wil S 1'rd - - , ••3 CONTRACTOR: NAME .•YTIME PHONE: b0`‘1ii &17/6ah26' g5 ) 3 k-g7Frc7 MAILING ADDRESS(STREET�I/ ,� ADDRESS;CITY, ATE,/u,ZIP). [/��j ? , &'4 c ', v4- `. q / !`Jvb i 01/4._ A �(�XD�j EVENING NING PHONE CITY OF FEDERAL WAY BUSINESS LICE E NUMBER{( ` FAX NUMBER: .2.0 '20 - 00-_10Z4 77 _ (253) S7 - //34- CONTRACTORS REGISTRATION NUMBER: ` EXPIRATION DATE: zAPPL (copy of card required) A(2 6 a i A41163_ 6/t- 9 / i 2 / 02- APPLICANT: ICANT: NAM DAYTIME PHONE: iin�Ddv/I4v6vv4 /Lleek (25 3) �3fr -77ka `(. r M2 62 3 W Vd`A �y/ZIP) A bvr �A / V 00n EVENING PHONE: S{-\` RELATIONSHIP TO PROJECT: /// FAX NUMBER: 4 ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE):P/bf N71-1r. (2S3 ) g'S7 -1/34- * E-MAIL ADDRESS: ` CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT CONTRACTOR ■',DETAILED BUILDING INFORMATION . EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ I PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ SPRINKLERED BUILDING? ❑ YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:❑ YES ❑ NO WATER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) a�oa5' 113 7 **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PROJECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? • TOTAL: ■ FIXTURES Indicate number of each type of fixture MECHANICAL AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) GAS LOG(S) REFRIG.SYSTEM(S) BBQ(S) FAN(S) HOOD(S) WOODSTOVE(S) BOILER(S) FIREPLACE INSERT(S) RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) GAS PIPE OUTLET(S HEAT SOURCE: ❑ ELECTRIC ❑ GAS LUMBING 6erx..444{ Cork---, P/ji ib,ie7 BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) ❑ ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLET GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) MI• DISCLAIMER/SIGNATURE BLOCK ` ' • 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 .. part of t)j.c-application. / NAME/TITLE: / is�I�' ,:fes / DATE: /2/(41.1(/ 1=1 PROPERTY OWNER ID APPLICANT CI CONTRACTOR 11 FOR OFFICE USE ONLY: Cl NEW ❑-'.ADDITION ❑ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION: BUILDING SHELL ONLY? `❑'YES ❑ NO COMP:PLAN DESIGNATION BASIC PLAN? ❑ YES I CI NO SECTION '- TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES I. NO PLATTED LOT? ❑ YES_ ❑ NO CHANGE OF USE? ❑ YES ❑ NO COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH-PO BOX 9718-FEDERAL WAY,WA 98063-9718-253-661-4000•FAX 253-661-4129