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20-102032-Building Permit ApplicationCITY OFOA�L PERMIT APPLICATION Federa PERMIT CENTER + 33325 8� Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permiteenter[Ncityoffederalway.com PERMIT NUMBER — _ TARGET DATE 2- J' 2,07 SITE ADORRES}S SWTE/UNIT # (� �/� r /�/ }� 3 -2J O, Y � � Y,1 (, li � "J r Fat? t? "U `� A� WA qY PROJECT VALUATION 1 oat o c� ZONING RE-5 �Ur* ASSESSORS TAXIPARCEL N 9 3 a- D -7 D TYPE OF PERMIT &1L.'ILDING ❑ PLummING ❑ MECI-I:INICLIL ❑ DE.Mou-rm ❑ ENGINEERING ❑ FfRE PREVENTION NAME OF PROJECT Q N RASE L-� q- KA- f r l P PROJECT DESCRIPTION Detailed descrrpiron of u>ork to x � G �Z 1 T F(Q T Lt1V A--Tf C? ) 1 �' � 6 � r '�^-T be included on this permit only k A --� QL V J: NAMB _ V-= j% 1 i\J �! 1� D ' " P-k ^ � MUMMY l!� PHONE 7 ~ c� e-�- PROPERTX OWNER hIA11,11NO ADDRESS 2 2 `3 �— EMAIL .tl olue R cm - - kL it I�Uri i� �o NAME W IA_ r � , VI PHONE `IC/�E I1A€1MG ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE TTB1 I NAM` q � j A Y` J V k v g� �rL� /�i PIiI1YfARX PHGNI � `'y APPLICANT J�� CITY �� ,� STA ZIPS 02,3 FAX Nam` 1 PRIMARY PRIMARY PHONE ` PROJECT CONTACT i�U 7 jM XmL�a� �t 1 �j- r�L'2,0 1M� , V (The individual to receive and respond to all correspondence }^ h STATE M _G 1llJ// yu 91-�f3Y FAX T I ~ concerning this application) PFMANCING NAMEROJECT ❑ OWNER -FINANCED When value is $5,000 or more (RCW 19.27.095) MAILING ADDRESS, CITY, sTA'rE, ZIP PHONE I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certify that to the beat of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with all applicable City of Federal Way regulations pertaining to the work authorised by the issuance of a permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating construction or environmental laws. I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attornegs' fees incurred in the investigation and defense of such clairn), which may be made by any person, including the undersigned, and filed against the city, but only where such claim arises out of the reliance of the city, including its offlcers and employees, upon the accuracy of the information supplied to the city as a part of this application. 5— �- ! 2 SIGNATURE: ATE PRINT NAME: Bulletin 9100 - February 19, 2020 Page 1 of 2 k;111audoutsTermit Application MECHANICAL PERMIT VALUE OF MECHAMCAL WORK Indicate horn marW o each type o Enure to be installed or relocated as part o this ProjecL Do not include e)dstmq fLxtures to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS jco=ema ) _ BOILERS FURNACES HOT WATER TANKS (G.) COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT VALUE OF PLUMBING WORK $ Indicate how mmuty of each type oLfbcha to be installed or relocated as part of this projecL Do not include m4sung ftxtures to remain. BATHTUBS,., LAVS(H—d S�' DISHWASHERS RAINWATER SYSTEMS DRAINS SHOWERS DRINKING FOUNTAINS SINKS jE,,L v/vajyj HOSE HIBBS SUMPS TOILETS WATER PIPING URINALS OTHER (Describe) VACUUM BREAKERS WATER HEATERS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL ON PROPERTY? N WATER PURVEYOR �� v �l SEWER PURVEYOR �� VALUE OF EXISTING GtPROVEMENrs $ zl 000, ®o EXISTING/PREVIOUS USE p� ,t S I �� T I A � LOT SIZE Iln Sq. Feet) N ©O EEISTmo FIRE SPRINW, SYSTEM? El Yes q , PROPOSED FIRE SUPPRESSION/SYSTEM? El Yes El116 RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE BASEMENT FIRST FLOOR (or Mobile Home) .............. ____.—____. ......... ___... _... _... .......... .. _ SECOND FLOOR COVERED ENTRY DECK.._. --___—.......... _—._....__.._—__-......._.._._.__.... GARAGE ❑ CARPORT ❑ .._....... OTHER (describe) Area Totals EEBTMG PROPOSED M n 2t/ f(pp "NEW HOSIES ONLY - ESTIMATED SELLING PRICE $ t �( # OF BEDROOMS COMMERCIAL — NEWIADDITION AREA DESCRIPTION Area in Square Feet Occupancy Group(s) Construction # of Stories Additional Information NEW BUILDING ADDITION COMMERCIAL — REMODFUTENAiNT IMPROVEMENTS AREA DESCRIPTION Area ttaro Feet Occu Group(s)Construction # of Stories Additional IDformation TOTAL BUILDING TENANT AREA ONLY PNo.IEcT AREA ONLY Bulletin #100- Febwary 19, 2020 Page 2 of 2 k:\Handouts\Permit Application