07-102422Ir.Rof A RECEIVA
Federal way PERMIT—
COMMUNITY DEVELOPMENT SERVICESF U 3 zXPPLICATION
7 SF MF CO ME EL PL DE EN
33325 D � AVENUE SOUTH • 63 BOX 97
Tu
FEDERAL WAY. WA 98063-9718
253-835-2607• FAX 253-835-ZfLo� Try
OF FEDERAL WAY
wwutciWofferieralwnu.co �
BUILDING DEPT.
The following is required itlformatton - an incomplete application will not be accepted. Please print legibly (in ink) or type.
SITEADDRESS 33j!057 �c�E• SUITE/UNIT #
ASSESSOR'S TAX/PARCEL # �o J d - �Q d LOT SIZE (sfl
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) A rT /T tL'7
(Alfach —parole pg, /— L—yMy 7ega1 de-acrWt0,V
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING XFIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit onlu)
Cj4A&jQt rtya--SFRj,LVtex1' -ro Qutck RjESPoaxe: ` ym 1A4
Nb W C,4E- jL4 $j ^ A&W DAA 2_^'P F1002 -
PROJECT NAME (Name of Business or Owner Last Name) F W44 QrPl I ct &4 46
PROPERTY
OWNER
CONTRACTOR
COPY of card reqed
with each appllc loa
PROJECT
CONTACT
LENDER
NAME
L, $ d} k9'L7-,4dA6 r 0"Ae'c NT
PRIMARY PHONE
(44.S) 72.7 10260
MAILING ADDRESS
�G o s .w. �,dy s fRe
CITYSTATE, ZIP
/Zrro/v W 4e i0f,
E-MAIL ADDRESS
C MPANY NAME
1'4lLcEi�/L C'd�cSr .�itLt
APPLICANT 11J eE
13006 �K4
OFFICE PHONE
(tss) $�t 7LL2
MAILING ADDRE
763-5-20 DM tT.
CITY. STATE, ZIP
Ajr Gt1. gMa% t-
CELL PHONE a�
(U&)&147 - ib%t±
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
101+C-310 - oo - to143 -Co-19L
EXPIRATION ATE
12. �l /o?
FAX NUMBER
(2116) SQL -*7L'77
CONTRACTOR'S REGISTRATION NUMBER
A•R04a: * zte MR
EXPIRATION DATE
Olt loci
E-MAIL ADDRESS
I
CO NAM r/�`
APPLICANTNAME
OFFICE PHONE
1 G ADDRESS
CITY. STATE. ZIP
CELL PHONE
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent ❑ Other
FAX NUMBER
NAME /�L PRIMARY PHONE E-MAIL ADDRESS
NAME
Per RCKr 19.27.095:
Lender information is required if project value exceeds $5,000
MAILING ADDRESS
CITY, STATE, ZIP
PHONE
( )
EXISTING USE 40 or F( e45 PROPOSED USE O F l— t CI.F-
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 4 1 SO
SPRINKLERED BUILDING? Y, YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
r;
® FOR COMPONETS OTHER THAN STAIRS: 84.6"
ED FOR STAIRS: 112.8"
VOLITION.
S 320TH ST
r��////, ; ;i,
cn
:BRATION'
PARK,
x
L-
U
o
Q
- -
CL
S 336TH ST
9
LEGAL DESCRIPTION 4
6 THRU 10 & WEST CAMPUS OFFICE PARK DIV 1 LOTS 6 THRU 10 OF WEST
CAMPUS OFFICE PARK DIV 1 TGW LOT i OF WEST CAMPUS OFFICE PARK DIV 2
DRAWING INDEX
DRAWING ISSUED
co co r`
w o 0 0
Q -t oo 00
0 0 o
N N r
OR PLATE - 1 "*04U
�-EN FRAL
G.0.0 COVER SHEET / PROJECT INF
G.0.1 PROJECT NOTES
C
1ST FLOOR
2ND FLOOR
PROJECT •••
AREA S
WOODSTOVES
AREA DESCRIPTION
77--
EXISTING PROPOSED
SQ. FT. SQ. FT.
TOTAL
SQ. FT.
BASEMENT
HOODS (Commercial)
BUILDING SHELL ONLY? c: YES ❑ NO
FIRST
RANGES
ZONING DESIGNATION
SECOND
6P ,•3 6
5(, �, G
THIRD
THIRD
URINALS
MISC (Describe)
ADDITIONAL FLOORS (DESCRIBE)
VACUUM BREAKERS
❑ NO
DECK (❑ COVERED OR ❑ UNCOVERED?)
WATER CLOSETS (Tmiel)
GARAGE ❑ CARPORT ❑
WASHING MACHINES
NUMBER OF FLOORS
Ex Ivo
4
PROPOSED
AL
TOTAL RXMTlNO SF TOTAL PROPOSED SF
TOTAL SF
M &72 -
2"NEW
"NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
.Indicate number of each type offixture to be installed or relocated as part of this project.: Do not include existing fixtures to remain.
MECHANICAL
Value of Mechanical Work $
AIR HANDLING UNITS
BBQS
BOILERS
COMPRESSORS
DUCTS
PLUMBING
BATHTUBS (or Tub/Shower Comb,)
DISHWASHERS
DRINKING FOUNTAINS
ELECTRIC WATER HEATERS
HOSE BIBBS
(A COPY OF BID OR ESTIMATE MUST BE INCLUDED WITH APPLICATION)
EVAPORATIVE COOLERS
GAS PIPE OUTLETS
WOODSTOVES
FANS
GAS WATER HEATERS
MISC (Describe)
FIREPLACE INSERTS
HOODS (Commercial)
BUILDING SHELL ONLY? c: YES ❑ NO
FURNACES
RANGES
ZONING DESIGNATION
GAS LOG SE1S, �
REFR[G. SYSTEMS
❑ NO
LAVS is,(hroom Si/s)
URINALS
MISC (Describe)
RAINWATER SYST
VACUUM BREAKERS
❑ NO
SHOWERS
WATER CLOSETS (Tmiel)
SINKS
WASHING MACHINES
SUMPS
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',jees 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. POL
INAME/TITLE DATE s/ 19/0 7
(Signature) — (Title(
RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor ❑ Architect OtherSd8 - L��%a=
FOR OFB'IE U51E E>NLiC
❑ NEW ❑ ADDITION
❑ ALTERATION
❑ REPAIR E TENANT IMPROVEMENT
BUILDING SHELL ONLY? c: YES ❑ NO
BASIC PLAN? ❑ YES
❑ NO
ZONING DESIGNATION
CHANGE OF USE? ❑ YES
❑ NO
NEW ADDRESS REQUIRED? ❑ YES ❑ NO
UP/SEPA/SU? ❑ YES
❑ NO
PLATTED LOT? ❑ YES ❑ NO
DEMO PERMIT REQUIRED? ❑ YES
❑ NO
Bulletin #100 - April 2, 2007 Page 2 of 4 k\Handouts\Permit Application