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02-105224 •arroOr G CONSTRUCT ION PERMIT APPLICATION 1 � IC Erz� RECEIVED APPLICATION NUMBER: D 2-- l DS 2 2- 4-f- DQ — FF APPLICATION NUMBER: - NoV 2 0 2002 APPLICATION NUMBER: _ _ - _ _ _ _ _ _ - _ _ **The fot(��y ation—Pleaseprint(in ink)or type** Cll Y�� FFfiCPP.YI�A� Please note: Electrical, Fire Pi� nf1`SiiirrTs and Engineering permits may require a separate application. � R• PROPERTY INFORMATION Si SITE ADDRESS: 3a/rO P•006//7;V- S. S°ASSESSOR'S TAX/PARCEL#: J -7 v--y. D - 0( . 0 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): ._. = -. - - is PRO]ECT INFORMATION-. -,. . , . _ . TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL`/❑ ENGINEERINGJFIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): ,45 ,aO /'-24E A+n` 1,,�.� PROJECT NAME: Chill/V4 ,41//V .�G!/V4 /2l jjl-tc},/'r- ni jPEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: ��c �c /�-re/%r ( ) - MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): CONTRACTOR: NAME: DAYTIME PHONE: FiR� „,- .S:n/ toe sr (36o ) cire - es-67 MAILING ADDRESS;i4aTY,STATE,ZIP): EVENING PHE: 2,7 b `SWEET/4ii< 61 ,— /3Lv o ' �kowMTC (5',11-0 )X79, V o / CITY OF FEDE WAY BUSINESS LICENSE NUMBER: FAX NUMBER: ( ) CONTRACTOR'S REGISTRATION NUMBER: J� / ff M/ /� EXPIRATIONTIDATE: (copy of card required) / / 'a CJ�� !C� / V / APPLICANT: NAME: V DAYTIME PHONE: �yvt per 777 ( I MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING P"`/ ,v fry cHONE: RELATIONSHIP,SXTO PROJECT: FAX NUMBEg ❑ ARCHITECT ❑ TENANT ❑ OTHER(DESCRIBE): ( ) qy3 - Y0S3 E-MAIL ADDRESS:/ CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER ❑ APPLICANT ❑ CONTRACTOR 7Nc Lek4)/G7J•/31%t-v • DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISEDSALUAIIO VL$ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ Z ,q.'' SPRINKLERED BUILDING? ❑ YES ElNO FIRE SUPP• SI• E •• •PO : - •• • • E • . e WATER SERVICE PROVIDER: El LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: 0 LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) **NEW RESIDENTIAL CONSTRUCTI)NLY** • NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PRO]ECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND 1 THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: y� �.c •,.vu,:a•t; :ycw:r.%w++s+. ';::.Awa-'+...t.... 444=a'4usatehtRi1.f:FEcruRG7'K" 'w!viY.,yr.0,0..:�r..444*rsNY+►iM$2-t!. avr"sk 41.4,v,-,..4.::....ani*a-+�..r44Mii.. 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 PLUMBING 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) -r::.. ' ..:.: . - 10-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(induding costs,expenses,and attorneys'fees incurred in the 1 investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of l 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. r/ NAME/TITLE: v/r DATE: //- ' J10 I , ❑ PROPERTY OWNER ❑ APPLICANT iii CONTRACTOR i FOR OFFICE USE ONLY: 1 Li NEW ,lam❑ADDITION aa 0 ALTERATION REPAIR. ,❑TENANT IMPROVEMENT -CENSUS,cODE 3�*3 A ,tA .s 4 ZONING'S ESI6NATYON ' Myrl •I BUILDING H LL ONLY? la YES © NO 4 f ICOM LAN DESIGNATION r - Tv+-Z-&-. 1`BASIC PLAN? ElES NO 's 1 .tggi9VV:71:::::-.-T:Elowroiip_vRANGE y., ;NEW ADDRESS REQUIRED? _ ❑YES ®,f 0 -' ,PLATTED'LOT?i ❑YES_ .0 NO = .. ;, ,:CHANGE OF USE? _' ' Q YES :`;-❑ r . '-:•"• COMMUNITY DEVELOPMENT SERVICFS•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.tityoffedera Tway-com