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19-104401 A. RECEIVED ^ CITY OF ...i SEP 12 2019 PERMIT APPLICATION Federal Way CITY OF FEDERAL WAY PERMIT CENTER+33325 8th Avenue South+ Federal Way,WA 98003-6325 253-835-2607 + FAX 253-835-2609 +permitcenter@cityoffederalway.com COMMUNITY DEVELOPMENT PERMIT NUMBER 11 _ 1 Q V y o J _ it/I TARGET DATE ! — 1 1 —�U/? SITE ADDRESS (.1)/9 SUITE/UNIT# /0 -. O S` L-11M ST- ii ; _• ' i ---0Eign-C w79Y;coSc;a3 ) 1 PROJECT VALUATION ZONING ASSESSOR'S TAX/PARCEL# $ 6.o a 4' z (4 q O _ O O gO TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING MECHANICAL ❑ DEMOLITION ❑ ENGINEERING E FIRE PREVENTION NAME OF PROJECT B Jo 5 CS 04---C) 7—/0 ti S PROJECT DESCRIPTION iV e79 r P�/Urn P Ix 57 "LOD 0 AJ C tl M.0)& 'c(/-(- Detailed description of work to 1 ) L: f t-O/N(-7 Rd d I , , �A!DoO,' /-, ?9-D S be included on this permit only I p 57LC--0 /A./ a G�F---rt cis NAME PRIMARY PHONE /MRS c W InIV7)9 j "ifPEr 7 5 2 c3-`1, a -/99 0 PROPERTY OWNER MAILING ADDRESS E-MAIL 5c 3 Pi3c) / y E-1,-.57-)IG- E-1,-.57- # a I)19 s CITY! /F� STATE�� ZIP 5 0\LI .^ NAME PHONE No Thwcsi E PE7 1171NG- LLC g53:- 398-6%Lig MAILING ADDRESSE-MAIL R)C4'9-?Oat CONTRACTOR 16 aO S. 3,-/9/U/ sr * CO ? No gl uiris EVA-iTNerb?iNGec OA, CITY STATE ZIP FAX re--v -6--11,91.. (v, )' cvA '7 Soo 3 WA STATE CONTRACTOR'S LICENSE# EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE# Noll.? ekiS33Dt . 3 / 15 [AI ©rl9,Io 03--ooh NAME PRIMARY PHONE /9N/7-29 57r)1GI Ai a 0 _2fD�-- Xo sh - MAILING ADDRESS f E-MAIL of 0....5--c:I._ APPLICANT /(9.A0 5. iti7TO 5/ 0.. 1 ii 5-OLV7-) ON5 CJ.0 CITY STATE ZIP FAX FE ,9-c. 0/79Y Vi9 ?goo 3 NAME PRIMARY PHONE PROJECT CONTACT A f C h).1--R 0 5c o /0 5-9'CI i-S V50' (The individual to receive and MAILING ADDRESS '/0�/ -7 E-MAIL I3) C)-1/9-RD e__,respond to all correspondence /0 0 -c 3 Y (/7 s-r #`�09 ,NC Ali 7-e71cRTHCn7i46,cC concerning this application) CITY STATE ZIP FAX Fe-17E W, Y w/9- 9°46c 3 NAME PROJECT FINANCING QI O-5'(----` 5 ol,u l/c. j NI OWNER-FINANCED When value is$5,000 or more MAILING ADDRESS,CITY,STATE,ZIP E-a- �T:9 L (,(�/-y PHONE (RCW 19.27.095) /©d?V 5, 3 ►-17 ' 5/ }�- I,?l l JT W 9$003 306 —$0 —Z0--5- 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 • ity as a pa. of this application. a. ,�— IIS DATE q`---)2-,3 6/ 9 SIGNATURE: . / PRINT NAME: /J C i-f/*P 9 'Hp, S C :77 _ , a Bulletin#100—January 29,2016 Page 1 of 2 k:\Handouts\Permit Application MECHANICAL PERMIT VALUE OF MECHANICAL WORK $ 6 ea Indicate how many of each type offixture 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) He.9"7—hIM p 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 SINKS(Kitchen/Utility) WATER HEATERS(Electric) HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS $ _ EXISTING/PREVIOUS USE LOT SIZE(In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? Yes No i Yes Li No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION(in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR(or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER(describe) EXISTING PROPOSED TOTAL Area Totals **NEW HOMES ONLY** ESTIMATED SELLING PRICE$ # OF BEDROOMS COMMERCIAL—NEW/ADDITION AREA DESCRIPTION Area in Occupancy Group(s) Construction #of Additional Information Square Feet Type Stories NEW BUILDING ADDITION COMMERCIAL—REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in Construction # of Occupancy Group(s) Additional Information Square Feet Type Stories TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin#100—January 29,2016 Page 2 of 2 k:\Handouts\Permit Application