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00-105847 103/00 MON 17:00 FAX 2536614129 CITY OF FEDERAL WAY Q002 Weetvet) arroP G CONSTRIRTION PERMIT APPLICATION 1v�? F[YtaciEmFrt_ LICATION NUMBER: QQ - l 4? - FP • OEC 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; 3 2 lO ` UG SU- ASSESSOR'S TAX/PARCEL#: 680"0090 LEGAL DESCRIPTION OF SUBJECT PR• •ERTY(ATTACH SEPARATE DESCRIPTION LENGT : /Y6 ZO 6o a, - A A 6 Al La J ' ' • a / _ J`J /A. • l PROJECT INFORMATION TYPE OF PROJECT(This application): - 0 BUILDING 0 PLUMBING 0 MECHANICAL 0 DEMOLITION • 0 ELECTRICAL ❑,q oENGINEERING,'FIRE PREVENTION SYSTEM PROJECT DESCRIPTION(Provide detailed description): /7�J'Urt gi<2 u4((/® /C/R6e- c..)ilii/ xA: i ' S/VS tiil1 PROJECT NAME: FSO W4 V C d/C/®4T7 CN7ZA' No/f r/4/ g• PEOPLE INFORMATION DAYTIE PHONE:PROPERTY OWNER: ©lCpEvtzo ',y�i�T 51/ LL (12S) 7•I Z OSZ 0 STATE, / � ST /0 7 LYNi/Woe, 7257.6V7 CONTRACTOR: NAME: DAYTIME PHONE: P/Xt /Xd 7- C-77194/ S)'J9 IS LLC (15-3) 35/ o SSV MAILING (STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE 3 96 Z w, t/.4 & /1 'Y M 1 ZvZ uso,rriv 1 9 (Z53) 3S7 - 08SY CITY Of FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER: Za - oo /0,5't_6 -008L (Z53) 3,S/ - O35-6 CONTRACTORS REGISTRATION NUMBER: E)B'IRATION DATE: F/X6 Zo I<I _ - s- / zo /zoo/ APPLICANT: NAME: DAYTIME PHONE: F/fie t, T C /ON S-YJ rree- 1J' GLC (ZrS3) 367-&954 MATUNG ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE S?cZ kt/, !//lCLi/# ' 'Y N 120 Z lie/g),</ /04. 9gO()/ (7.53)3S"i - 68S11 RELATIONSHIP TO PROJECT: FAX NUMBER: 0 ARCHITECT 0 TENANT 'OTHER(DESCRIBE): N 7R ( )35( -08g6.- E-MAIL 8S6EMIL ADDRESS: CONTACT PERSON FOR THIS PROJECT: 0 PROPERTY OWNER 0 APPLICANT XCONTRACTOR `- DETAILED BUILDING INFORMATION EXISTING USE: EXISTING BUILDING ASSESSED/APPRAISED VALUATION $ ' r-7 PROPOSED USE: . PROPOSED VALUATION FOR IMPROVEMENTS: $ 7 /J 700" p0 SPRINKLERED BUILDING? -)54.YES 0 NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED: "YES 0 NO WATER SERVICE PROVIDER: .1LAKEHAVEN 0 HIGHUNE ❑TACOMA 0 PRIVATE(WELL) SEWER SERVICE PROVIDER: 0 LAKEHAVEN 0 HIGHLINE 0 PRIVATE(SEPTIC) 1123/00 MON 17:00 FAX 2536614129 CITY OF FEDERAL WAY 11003 **NW RESIDENTIAL CONSTRUCiIO�LY** • NUMBER OF BEDROOMS: ESTIMATED SELLING PRICE: $ ■ PROTECT FLOOR AREAS FLOOR EXISTING SQ.FT. PROPOSED SQ.FT. TOTAL BASEMENT FIRST SECOND - THIRD FOURTH OTHER FLOORS(DESCRIBE) DECK GARAGE HOW MANY FLOORS? TOTAL: Indicate number of each type ofof fixtu'ej MECHANICAL Vik «-- Bt�NDLING UNif(S) EVAPORATIVE COOLER(S) GAS),4�(Si REFRIG.SYSTEM(S) BOILER(S) FIREPLACE INSERT(S) GGEE(Sj fcoeRPP�.a„, MISC. ($) ) COMPRESSOR(S) R$RNACE(S) DE DUCC(S) GAS PIPE OUTLET(S) G' RCE: 0 ELECTRIC Q GAS PLUMBING BATHTUBS) tAVATORY(S) URINAL(S) WATER HEATER(S) DISHWASHER(S) RAIN WATER SYS. VACUUM BREAKER(S) 0 ELECTRIC 0 GAS DRINKING FOUNTAINS) SHOWER(S) WASH MACHINE OUTLET • „ INNTTERRCCEPTOR(S)OUTLET(S) SINK(S) $ WATER CLOSET(S) MISC.( SUMP(S) t4 DISCLAIMER/SIGNATURE BLOCK I certify Under penalty of perjury that the information furnished by me is hue 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 hanutess the Cay of Federal Way as to any claim(including costs,expenses,and attorneys'fees Incurred In the Investigation and defense of such dein),which may be made by any person,including the undersigned,and Med against the City of Federal Way,but only where suds claim arises out of the reliance of the dty,Including its officers and employees,upon the accuracy, of the Information • ed to the dty as a pa ,• this application. NAME/TIn E. /C 6 DATE: /Z—/— CI Z~/—❑PROPERTY OWNER 0 APPLICANT CONTRACTOR 1<t e ).- L"" Y� R E� TR w y5 1 lii' 'Y Ti.. i c`j y as 1.>�Y� i�`3. (et / /j�.w�e� ��� �k'pk�P � ��,.�.�-,� �.,����� .� ��i.l�j'P r �. '..��� � �i INVDY OEVELOPt4ENT SBtV[CE$•33530 FIRST WAY SOUTH•PA.BOX 9716•FT32FRAL WAY,WA 980614716•253461.4000•FAX:253-661.4129