06-101164 �
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Federal way P E R M I T ��� �"�-
COMMUMTYDEVELOPMENTSERVIc��� � � ���� SF MF CO ME EL PL DE EN P
33325 BTxAVEMlE SOUTH.�BOX ��p L I C AT I O N
FEDERAL WAY,WA 98063-9718 D / /
253•835-2607•Fax�Ss-s35-aTY OF �EDERAL `
«�ium.cihroffederQlwau.�i
BUILDING DEPT.
The oilowin is re uired in orma.tion-an inco lete a iication wili not be acce ted. Please rint ie i6l in in or
.� . � . �
SITE ADDRESS f South Commons, Space #6278 SUITE/UNIT�
ASSESSOR'S TAX/PARCEL# _ _ _ _ _ _- _ _ _ _ LOT SIZE(s�
LEGAL DESCRIPTION (e.g.Acme Estates,Lot I)
/Attarh separate page jor lengthy legal descriptionJ
'• • ' •
TYPE OF PERMIT ❑ BUII.DING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING �Q FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this oermit onlul
Add 80 sprinkler heads
PROJECT NAME(Name of Business or Owner Last Name) L a n e B r va n t
. • . • .
PROPERTY NAME /� PRIMARY PHONE
OWNER ( ) -
MAILIN ADDRESS CITY,STATE,ZIP
CONTRACTOR COMPANY NAME APPLICANT NAME OFF[CE PHONE
Crown Fire Protection, Inc. Mark Holey ( 425 ) 481 - 7669
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE
P.O. Box 12113 Mill Creek, WA 98082 ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE FAX NUMBER
.� �- � $- 1 0 5 6 6 1 - B L 12 / 31 / 2006 ( 425 1 481 - 8695
CONTRACTOR'S REGISTRATION NUMBER(copy of cazd requirad with each applicatioa) EXPIRATION DATE
� .g � W I� � P Q 4 4 L _L 4 � 8 � 07
APPLICANT COMPANY NAME APPLICANT NAME OFFICE PHONE
Crown Fire Protection, Inc. Mark Hole ( 425 ) 481 - 7669
MAILING ADDRESS CITY,STATE,ZIP CELL PHONE -
WA 98082 ( ) -
RELP.TIONSHiP TO PROJECT FAX NUMBER
❑ Architect ❑ Tenant ❑Agent [�(Other(DescribeJ_C011tY'dCtOY' ( 425 ) 481 - 8695
CONTACT NAME PRIMARY PHONE E-MAIL ADDRESS
Mark Hole 425 481 - 7669
LENDER Per RCW'19.27.095: Lender ir{formation is NAME
requireti�f prrofect vaiue exceeda�5,000
MAILING ADDRESS � CITY,STATE,ZIP
� � : � • • •
ExisTu�G vsE ___ Reta i 1 PROPOSED USE Reta i 1
EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ �8,OOO.00
SPRINKLERED BUII.DING? �YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? O YES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA � PRIVATE(WELL)
'SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGFILINE ❑ PRIVATE(SEPTIC)
�
, .
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AREA DESCRIPTION EXISTING PROPOSED TOTAL
S . FT. S .FT. S . FT.
BASEMENT
FIRST
SECOND
THIRD
FOURTH
ADDITIONAL FLOORS(DESCRIBE)
DECK(COVERED?)
GARAGE O CARPORT❑
NUMBER OF FLOORS BQ°'�'"c PROP08SD TOTAL TOTAL S77�BiDt6 BF ror,v,r,eorosau s. mr,,,,sr
**NEW HOMES ONLY** NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $
Indicate number of each type of furture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
1{�CHAIVICAL
Value of Mechanical Work $
AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG.SYSTEMS
BBQS FANS HOODS(commercial) WOODSTOVES
BOILERS FIREPLACE INSERTS RANGES MISC(Describe)
COMPRESSORS FURNACES GAS WATER HEATERS
DUCTS GAS PIPE OUTLETS
PLUMBING
BATHTUBS(or7ub/showercomno� SHOWERS WATER CIASEI'S�ro��q MISC(Describe)
DISHWASHERS SINKS DRINKING FOUNTAINS
GAS PIPE OUTLETS SUMPS RAINWATER SYST
WASHING MACHINES URINALS HOSE BIBBS
LAVS�sati„oom s;nke� VACUUM BREAKERS ELECTRIC WATER HEATERS
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I certify under penaIty of per,jury that the ir4format{on furnished by me{s true and correct to the 6est of my knowiedge, and further,that I
am authorized by the owner of the above premises to perforni the work for which the permit appIicatton is made. I further agree to hold
harmless the City of Federai Way as to arty claim(including costs, expenses, and attorneya'fees{ncurred{n the investigation and defense of
such clai�,which may be made by any person,tncluding the unders�gned,and fiied agatnst the City of Fedeml Way,but only where such clatm
artses out of the reliance of the ctty,tncIudtng its ofj?cers and employees,upon the accuracy of the t�(ormatton suppited to the city as a part of
this application.
NAME/TITLE (�IJIY� > �S P/ // DATE c�I`7 /V lP
(Signature) ^—r
(TiUe)
RELATIONSHIP TO PROJECT ❑ Owner 0 Agent �Contractor ❑ Architect ❑ Other
FOR OFEICE USE ONLY, .,.
a NEW ❑'ADDITION ❑ALTERATION ❑REPAIR ❑'TENANT IMPROVEMENT
BUILDING'-SHELL ONLY? ' ❑YES ❑NO' BA3IC PLAN? ❑YES o N0
ZONING DESIGNATION 'CHANGE OF USE? ❑YES ❑NO
NEW ADDRESS REQUIRED? n YES' ❑NO' UP/SEPA/SUP ❑YES ❑NO
PLATTED LOTP o YES" o NO . DEMO PERMIT REQUIRED? ❑YES ❑NO