The URL can be used to link to this page

02-104113 :F7 Atlip' crrr of • t C. �� CONS I/RUC I ION PERMIT APPLICATION �� RECEIVED APPLICA ON NUMBER: S)L; 1 U + C�I6\�� .►�) SEP 2 3 2002 APPLI TION NUMBER: - - APPLI TION NUMBER: _ _ - _ _ _ __ - **The follovZiFi etRiO{ AtTWAIsrl—Pleas print(in ink)or type** Please note: Electrical, Fire Prevention BUILDING and Engineering 9 g permits may require a separate application. PROPERTY INFORMATION SITE ADDRESS: ASSESSOR'S TAX/PARCEL #: LEGAL DESCRIPTION OF SUBJECT PROPERTY(ATTACH SEPARATE DESCRIPTION IF LENGTHY): _::._ 7 };; :._i , .11 PROJECT INFORMATION-::-: v . . . . . TYPE OF PROJECT(This application): BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL� ❑ ENGINEERING❑ FIRE PREVENTION SYSTEM / PROJECT DESCRIPTION (Provide detailed description): ( oIJSTe_o_CT p. NgAki 4 gEpecnt, , 2 / B INC-,LE F. .. L. t DE.- - T1 L • A. . PROJECT NAME: 6TAR LAKE ,Jtfr•4 _Sat- Th I,_b i 4O { 7 -(1-4.46--,t /J . :a a PEOPLE INFORMATION . .t_ PROPERTY OWNER: NAME: DAYTIME PHONE: SCAN)EI DER_ \--V3-,\E5 l tQC.. C206)2118 -gin/ MAILING ADDRESS(STREET ADDRESS;QTY,STATE,ZIP): (o51O SOUTNCENTf BL vD -rm 1 t \a gC31 B , CONTRACTOR: NAME: DAYTIME PHONE: LCliNErDE2. Hotos kr_. (2( o )Zy$ -247/ _ MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: (D5Ib GOUTNCEN-i )LvD SkwltA WA 9818f3 �Po ),4S -247/ cm'OF FEDERAL WAY BUSINESS LICENSE NUMBER: , FAX NUMBER: 19_ - 9_91b_710 24 - ooh (z0, )24z -42Dai CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE: (copy o(card required) SC.. i-INEZ• 2' 5 P13 - - 03 /o' i0,3 APPLICANT: NAME: T � � DAYTIME PHONE: H- (20G)ZI -22/7/ MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE: (.05(I Q -• - . ► , . I . . ; '8/88 IVO)211. -2471 RELATIONSHIP TO PROJECT: FAX NUMBER: ❑ ARCHITECT ❑ TENANT )OTHER(DESCRIBE)?RQ,3, ?LANA( .. (24t6 )2'Z -42c)9 E-MAIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: ❑ PROPERTY OWNER AAPPLICANT. ❑ CONTRACTOR • I.A DETAILED BUILDING INFORMATION ' EXISTING USE: — EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ PROPOSED USE: SI F. R. PROPOSED VALUATION FOR IMPROVEMENTS: $ I BO/ OCO SPRINKLERED BUILDING? ❑ YES Ig( NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED:0 YES ] NO WATER SERVICE PROVIDER: >4 LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE(WELL) SEWER SERVICE PROVIDER: XLAKEHAVEN ❑ HIGHLINE ❑ PRIVATE(SEPTIC) KciYa9Va3A. **NEW RESIDENTIAL CONSTRUCTIO•LY** / NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ f 2.0)Ocip - 11 PROJECT FLOOR AREAS - FLOOR EXISTING SQ. FT. PROPOSED SQ.FT. TOTAL BASEMENT 7- ` FIRST 7-- -___ Y 124/0 S.F. /2zIO 6•F• SECOND ) / / Z S. . I I [r r 7 Si THIRD ------ , FOURTH ^ / ^ - OTHER FLOORS(DESCRIBE) - DECK / GARAGE HOW MANY FLOORS? I 055.F 5 •i 705 –� TOTAL: 0 3 S•F. 30575.5.S .F. -..-c-..,., „.e+.:..:.::+v..•i, -•:„. w�•esNa4,1, atY.is4*;44;RMYK xv,.c F=ATVREs.g.,;...i. iia•jnr;,,.:•.—,.i•+. i,,.:,r,,,,•;3e. +,:„-wv.i....r.Mw.:.+m—,, -v a:ti•ii. Indicate number of each type of fixture MECHANICAL I AIR HANDLING UNIT(S) EVAPORATIVE COOLER(S) I GAS LOG(S) 1 REFRIG.SYSTEM(S) BBQ(S) FAN(S) l HOOD(S) WOODSTOVE(S) BOILER(S) I FIREPLACE INSERT(S) 1 RANGE(S) MISC.( ) COMPRESSOR(S) FURNACE(S) DUCT(S) Z.. GAS PIPE OUTLET(S) HEAT SOURCE: ❑ ELECTRIC , GAS �! PLUMBING 2 BATHTUB(S) <1 LAVATORY(S) URINAL(S) J WATER HEATER(S) i DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) El ELECTRIC GAS DRINKING FOUNTAIN(S) SHOWER(S) I WASH MACHINE OUTLET j GAS PIPE OUTLET(S) Z. SINK(S) 3 WATER CLOSET(S) MISC.( ) INTERCEPTOR(S) SUMP(S) '-':•"!.e.::-.'",*::,?. :4'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 daim(induding costs,expenses,and attorneys'fees incurred in the investigation and defense of such daim),which may be made by any person,induding the undersigned,and filed against the City of Federal Way,but only where such daim 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: �' '�� - DATE: 2„eR__ -'. ❑ PROPERTY OWNER JL APPLICANT ❑ CONTRACTOR =FOROFFICEUSE tiN Lir 1NL_ ' Ii ADDITION '.. "LTERATION,,, £ REPAIR ..,E+0rTENANTIf PROVEMENT,�:, z . .. _ ". it s ,� r .... sir kS-' ¢i-5 a'-�... 'ry Y �. r..,�. -CENSUS CObE:�� ,: '. �n-�:- . ;�� SLOT: IZE � �,z � _.� -. 4 O G-P . NA ONM T 2-" ' ` BUILDI_ GSHELONOf LY ` 1'r YES ©., •-P DFS'I.G A ION S --, y "$BASIC El.A ? rilA -•ES o'''-4-4:4,--se- E; :. .. Tc .�e� ;pr '..s' "'Tr nw• r k aka f ••L rs ' �SECiTON�� TOWNSHIP �RANGE� � ,� N � DDRESS RE�1'�IRED ,� �� (� � M M '.S+3h'� 4S:r� `-� � �� , �fES�r!❑aN�o�• �+s�r�£ � �+,s ,r z � � 2s'+ lr� ;s•.a w=a.,�.. �� ❑.;�r�J��,� 'r- '�`-tx.�, . SPL CTf D LOT? ❑ ES,� O - k •=.CHANGE OE,TSE?, '=.xr. .. ��" ` . COMMUNITY DEVELOPMENT SERVICES•33530 FIRST WAY SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4000•FAX:253-661-4129 www.dNofederaIwaV.com