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06-105914 ir RECEIVAI CONSTRUCIJN PERMIT APPLICATION gTYOF u - �'�0L_1 5 2006 APPLICATION NUMBER: (}( - ( O v 1 - ` APPLICATION NUMBER: - - CITY OF FEDERAL WAY APPLICATION NUMBER: - - BUILDING DEPT. **The following is required information—Please print(in ink)or type** Please note: Electrical,Fire Prevention Systems and Engineering permits may require a separate application. • PROPERTY INFORMATION SITE ADDRESS: 2'-60 i3 �� 101-3 TAX ASSESSOR'S TAX/PARCEL# 01 Z t 0 3R ( 3 0 LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): 2iio 4 110 u;` fka E a - - l © ` 142-7 z 00 5(,)4 00004 SP LLA g i 1&T wi A-rrik i,'J PoC. t NE 1/4 pF mow' 1/4 or cc( I - 7 4 - 3 L y C-Ly of L.Q-rS 3 ' 4 f K Of t►V TA ADA • • • PROJECT INFORMATION TYPE OF PROJECT(This application): ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION o ELECTRICAL ❑ ENGINEERING FIRE PREVENTION SYSTEM ". PROJECT DESCRIPTION(Provide detailed description): p w4;?iZ LN s9S 1 Y1/l t ,• iti C: v SIN C�Le F"/},M 1 Lkt I1c5•oc,of�C PROJECT NAME: - %}�`7i!�, •-- & )LLt k ;>t c'3(4 • PEOPLE INFORMATION PROPERTY OWNER: NAME: DAYTIME PHONE: t.A i t�C M A (1--Tr.iV )4G20 --- 7 y f; 2-- MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): Z1.o4 .� 3oc�^ Y� c( c&3 CONTRACTOR: NAME: DAYTIME PHONE: Fire Systems West,Inc. 253-833-1248 MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: 219 FRONTAGE ROAD NORTH,SUITE B, PACIFIC,WA 98047 ( ) - CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: 19 -87-000014-0061 253-735-0113 CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy of card required) FIRE SWI 14 0 B 1 12/31 APPLICANT: NAME: DAYTIME PHONE: SAME AS ABOVE 1 E D CV.1tZ MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: F(2_c F.FtCC/ Ago:,g RELATIONSHIP TO PROJECT: �—� FAX NUMBER: ❑ ARCHITECT ❑ TENANT X OTHER(DESCRIBEr SPRINKLER CONTRACTOR` SAME AS ABOVE ----------------- E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER X APPLICANT o CONTRACTOR - 5.-.4 r.� y. J Co • DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: PROPOSED VALUATION FOR IMPROVEMENTS: $ i i SPRINKLERED BUILDING? et,,YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: o YES 0 NO WATER SERVICE PROVIDER: XsLAKEHAVEN ❑ HIGHLINE o TACOMA o PRIVATE(WELL) SEWER SERVICE PROVIDER: o LAKEHAVEN ❑ HIGHLINE o PRIVATE(SEPTIC) �+ • • • **NEW RESIDENTIAL CONSTRUCTION ONLY** NUMBER OF BEDROOMS: 2 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: 11 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 PLUMBING BATHTUB(S) LAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) o ELECTRIC ❑ GAS DRINKING FOUNTAIN(S) SHOWER(S) WASH MACHINE OUTLETC-7_,.."Th F "�c GAS PIPE OUTLET(S) SINK(S) WATER CLOSET(S) o / MISC.( `•"`LINTERCEPTOR(S) SUMP(S) ' 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 as a part of this application. NAME/TITLE: J.1� DATE: 1( I ❑ PROPERTY OWNER cAPPLICANT ❑ CONTRACTOR FOR OFFICE USE ONLY: ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ TENANT IMPROVEMENT CENSUS CODE: LOT SIZE: ZONING DESIGNATION : BUILDING SHELL ONLY? o YES ❑ NO COMP PLAN DESIGNATION BASIC PLAN? ❑ YES ❑ NO SECTION TOWNSHIP RANGE NEW ADDRESS REQUIRED? ❑ YES ❑ NO PLATTED LOT? ❑ YES ❑ NO CHANGE OF USE? ❑ YES o NO COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.cityoffederalway.com