20-102051-Building Permit Application-05-26-2020-V1i:41k
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Federal 1y
PERMIT NUMBER
PERMIT APPLICATION
PERMT CENTER + 33325 81h Avenue South + Ptdemi Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + pmnitC"bcr*i y0Rdera1>•way-tofn
TARGET J}ATE
SITE ACCRIMS N
PROJECT VALUATIOA
80MINA
AsMngoxll} TAX/PA]WR1 #
TYPE OP PERMIT
N tsV€LDMG 11 PLUMBING ❑ MECHAN€CAE. 11 DEMOLIT€ON ❑ ENGINEERING ❑ FIRS PftleENTJON
NAME OF PROJECT
ct4 ( 4 4 !-dip. Ybo
>E'RU.JEC7,` DESCRI]PTICH
Detaited description of "rk to
be included on this permit only
f
NAME /�
UA L
PR PHONE
-
PROPERTY OWNER
MiULMG ADD 1}
E.MjUF,
c in 11rA,T6
L
ZIP
r
_
HAMS
PHONE;
MMLIPM AQDREW
E-MAIL
CONTRACTOR
40IT4
IMT&
21P
FAX
WA STATE CONTRACTOWS LICENSE R
EXPfFLATUM DATE
H D=ZAL WAY UU 91NE ss LwEtFsg n
- -
NAMES
YR15tMRY YIIONE ---
MAILITIRARORr4JU
E-MAIL
APPLICA19T
C,ITV STATE
- - -
ZIP
F•AX
PROJECT CONTACT
NAME
r
PRINLARY PHONE
U&ILING APPRASES
1�]AAII.
I 1 individual to 1 ac6tre and
respond to all correspondence
CITY
9TAT4
11Y
YAX �
concerning this appii=iar4
PR{}JD T FINANCING
mAe�e
0 owNF,R-FiwAP(CL-D
i
White Wab,e iS $6, 000 4r Mar*
MAILEEG ADDRMS, CITY, STATE, SIP
PHONE
! eer[!f�r underpenerteg of perjury that i am ehc ta"FwtfV owner or authorized agent of the property ousear, 7 aer#(f4y that to the bast
of my knowledge, tiie iz;formation submitted in su,ppart of this permit appliddtion is true and eorreot- I cerrvy that I iWit comply witk
all app[ira bts City of Atdera[ %Fogy r µtat�v" pCre41xtiruj to the work authorized by the isavorrecs of A permit. I understand that the
iSFFFanCe of thiS permit does not Famone the owners respvneibil'ity for compilanve uAth local, state, or ftdaral laws regulating
Gonstru4ndon Or eRv&ofxm!E#eut !or{y$,
i f3trt wr PWrea to hold harm less the City of Federal Wag as to any elabn (including costs, expenses, and a rwraegs" fees Incurred in
the investlgatiort and defery4e of such &jairV, which may b! #tack by any per"u, inclu4iny the undersigned, and fixed agag st the ei%%
${ai` #Esl�r wh4FV such eiaim Rrfses ou# of the reliance of the oily, including its ofcars and employeaa, upon the accuracp of the
tnformatiost satpplied to the oley ax a part of thk ccppticaVOM
SIGNATURM DATE r .. �L_,! Cr _
PRINT RAM-
13 ul lcun 0 100 —January 24, 2016 Page I of 2 k AHandoutsTermi t Application
MECRANICAL PERMIT
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RIAGRIGEPARON SYST
PLUMBING PERMIT
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GENERAL INFO ION
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Area Totals
100
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ESTIMATED SLUNG PRPCE A Or BEDROOMS
COMMERCW.—NE WADDITION
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COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
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Bullelie 01 W-January 29,2016 Pepe 2 of3 YVIon6ewaVemnt Applic&iw