20-102594-Building Permit Application-06-30-2020-V1CITY OF
Federal Way
PERMIT NUMBER
PERMIT APPLICATION
PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325
253-83S-2607 + FAX 253-835-2609 + permiteenter(ceityoffederaiway.com
TARGET DATE Q
SITE ADDRESS
SUITE/UNIT #
3-115-7 334 Ave- Si�
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
TYPE OF PERMIT
ATISUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
R{ee)ace. Jec k
ire-ef2Llil ,A - 40 dgLckL �o i�t f�f� G
PROJECT DESCRIPTION
or
Detailed description of work to
be included on Otis permit only
NAME A
A
PRIMARY PHONE
Kai*, v i J4�f_�y'�
Z5-3-5-17- 331-F
PROPERTY OWNER
MAILING ADDRESS
3a 15- _13n2 -s a-J
E-MAIL
CITY
1
STA E
ZIP
9JP62-3
NAME tI_
b.n C� (6'reaAu �d r,S f.L�
PHONE
2�3-�Ts►-79a8
FAILING ADDRESS
CONTRACTOR
Z S I St
CITY !� �� STATE
ts*
Q( 03r
(�
FAX
WA STATE coxTRKcTowS LICENSE #
6967,5ml a L_? CIL-
EXPIRATION DATE
02. / 11 / Z)
UBI #
603 -Tj t 261-
NAME �
ow, �
PRIMARY PHONE
APPLICANT
MAILING ADDRESS
E-MAIL �SLAH&
Z S1
CITY
Nd q lie
w A-
q,?0 3,F
FAX
NAME
PRIMARY PHONE /
PROJECT CONTACT
^
fThe individual to receive and
MAILING ADDRESS
2-q� �
EMAIL a
J�q
�"
respond to all correspondence
I
,Qe CITY II
/ VW
STATE
ZIP
PAX
concerning this application)
PROJECT FINANCING
NAME g�
/ � ,v f
OWNER -FINANCED
When value is $5, 000 or more
(P.CW 19,27.095)
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
I certify under penalty of perjury that I am the property owner or authorised agent of the property owner. I certo that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. 1 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 pray as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), 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 officers and employees, upon the accuracy of the
Information supplie to the c as a part of this application.
SIGNATURE: DATE 3 6�i�
/�' �
PRINT NAME 64 ` -
Bulletin #100 —February 19, 2020 Page I of 2 k:U-landoutslPenuit Application
VALUE. OF MECHANICAL WORK
MECHANICAL PERMIT
AIR HANDLING UNITS
FANS
_ GAS PIPE OUTLETS OTHER (Describe)
_ AIR CONDITIONER
FIREPLACE INSERTS
_ HOODS icommcm;m)
_ BOILERS
FURNACES
HOT WATER TANKS im.)
_ COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
DUCTING
GAS PIPING
WOODSTOVES
PLUMBING PERMIT
VALVE OF PLUMBING WORK
$
Indicate how many of each type of fLcture to be installed or relocated as
partgLthirs project. Do not include existing.fcaures to remain.
BATHTUBS (orme/shower Combo) LAVS iHana Sams)
_ DISHWASHERS RAINWATER SYSTEMS
DRAINS SHOWERS
DRINKING FOUNTAINS SINKS
HOSE BIBBS SUMPS
TOILETS WATER PIPING
URINALS OTIIER (Describe)
VACUUM BREAKERS
WATER HEATERS (eiermm�
WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS
$
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
I.1 Yes ❑ No
PROPOSED FIRE SUPPRESSION SYSTEM?
i., Yes I:! No
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..
-T-20.SI4
�I.li
S
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals
S81STING
FROP ED
TOTAL
................
k•NEW $ONES ONLF"*
ESTIMATED SELLING PRICE $
# OF BEDROOMS ::j
COMMERCIAL — NEW/ADDITION
AREA DESCRIPTION
Area in
S uare Feet
Occupancy Groups)
Construction
a
# of
Stories
Additional Informatioa
NEW BUILDING
ADDITION
COMMERCIAL —REMODEUTENANT IMPROVEMENTS
AREA DESCRIPTION
Area /n
square Feet
Occupancy Group(a)
Construction
a
# of
Stories
Additional Informatioa
TOTAL BUILDING
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin # 100 - February 19, 2020 Page 2 of 2 k:\Handouts\Pcnnit Application