20-101797 RECEIVED
CM A PERMIT MAY 0 2 2020 APPLICATION
FederFederal W PERMIT CENTER.33325 Avenue la.rurh + Federal Way, WA Q8003 6325
al OF FEDERAL Y 233-835 2607 • FAX 253-835.2ryf)9 ♦p trrntrrrac)tpoftederalwav Tom
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PROJZCT VALUATION � 1
tARIlIO ' A/R�O1111 TAX/PANCEL•
TYPE OP PEWIT! i Iiliil.,pry(: ❑ P,I'bEIII t: U MBCI1ANICAt. LI D MtlLIT1ON n )ay.INKI'KING C FIHF.Pim,. i'T1U'S
NAME OP PROJECT 1
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PROJECT DESCRIPTION / / /. 1 -` I
Detailed desert/non o u.rrrk to ' t1}ik.-4 L C _ . CIS't•.‘-‘•pit% ii C . III t") / t!'i Yl.i_.(IS I-A-
b i.cjuded on this permit orlhr }l
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was - PIUNAlT MOUS
PROPERTY OWNER I A 1 1,it ��1 i t r r.,4.,c `2,t)(., 4 cei (I r. ,/
>AMIRO SIMIS1r 0-Nut.
, 3.2--I iH . Z r�u A 6 ti S...; , ,tiut ,t.--(4.;,y„><.,I t cc..,
! CITY ' STATS ZIP
V epee AL AY _ 0,4‘ (q'!'.'-2�
MANS MOSS '
NAUJNO At1Or/V it aim
CONTRACTOR ! t�r1r i/
MILTS MPTAR
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WA'PATs COisTRAtTOO a manna• SStIIATIOO DATA VIII r
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timet Fi` Iii S/t ry i' f 1.fr. rrNtsas MOIR
APPLICANT NA)""0�� I NAG.
')) �3 ' '772.,i) AUL S _ ___
NANN A rimNASI Peon
PROJECT CONTACT t 1 ' 1 f ev t1 t tc:_C=�R 1 "2-64 qt. i (I.)9 L
+e IndtrnduaI to re or and Nwt
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reepc nd to cat correspondence �i Z i 4 3.'N I) A y t
mfloTrnlr,q t&14 opplI,rhtIOrlI CiTY •TATS ZIP FAX
It FerZAI_ C)AI A qt
PROJECT PINANCINO Qr owirta.rNIANCED
When n ralur ra 55.900 a.+s01.2 11A16010 Asloaw.CRT.'TATE m P100*
.Y+'_'iv:ir:;crr;:,
t certify leads penal of p.ry'ary that I aha the property owner or autMAa.d opted of the property manor.I..rq/y that to deo boot
of ay knowledge,two tiara to w submitted In support el this permit gyRctttion is trim and correct.I cortin that I sal comply alit
ail appl lank.City.f/.doral Way regulations pertaining to the work.otheri..d by the ts.aance.f a porta I uud.r.tawd that ttt
t.oaance of this permit dear not mum, tAo ..wores r amail.atn4r par cornpito c. t.M1h haat, 'oat., or federal Mem Pup tatty
cow.truta.w.r enutruswee.tal Ia...
I farther swat to holt harmless the City of Adored Way as to amp elatat rywrtudtng coots,.up nate,and.a.en po•foes tweurr d to
U. toweety.a.rt and do/.w.et of each ciatay,which nosy be mads by any parson,tOClnd/wy the w>t rstp..d,and filed ap.iw.t tad city,
but ally whom sash claim arises out of the toti®too of the city, tar-hiding Its dicers sod atuploy.ea, wean the aectiraty of the
inforatattat.opp Red to the any as a part of this application.
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SIGNATURE: �ht.... I .yw.�- DATE 5- - 2-c` l..'
PRINT NAMs: A1 h-nµr-2,-> h I i1(. 1. t
Bulletin AIQO 1-c-hntnr) 19,2020 Pngc 1 of 2 k•'.Han&k ut Peritl,t,Application