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08-103571Sm ar �` �� I - -L a a � 7-L FederalWay�ECEI. Elk RMIT COMMUNITY DBVBLOPMBRTSERVICES SF MF CO ME EL PL DE E FP 3334FR RAL WAY, WA 9 • PO BOX 9718 JUL "APPLICATION 53-83 AL WAY, FAX 53-8 3-9718 Z59.89SZ607• FAX Z53�35-2609 II MY®FF"XRAL1NP The following is required ir{foct�q n - an inca fete application Mill not be accepted. Please print legibly (in ink) or type. j SITE ADDRESS _ Q -z 5 let, CIA � Tic AL'4 �11 . CC Cl fl4i l SUITE/UNIT # ASSESSOR'S TAX/PARCEL # _ _ _ _ - _ _ _ _ LOT SIZE (sj LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) (AttaM separate pwf-1-gfhy lmd d—vO faN PROJECT•• • TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING '�-FIRE PREVENTION SYSTEM PROJECT NAME (Name of Business or Owner Last Name) ` l 16►-'�'\p. Lam!) P-C/X1"0y\ PROPERTY OWNER CONTRACTOR P APPLICANT PROJECT CONTACT LENDER NAME o PRIMARY PRONE K(�M ) 6�'� - 0 0 3 MAILING ADDRESS � S'❑ Z S �nCkAnj PCO. '� � CITY STATE, 4W '� f j:�:�d3 E-MAIL ADDRIM MAILINO AD7ESS STALE, Z[P CITY , CELL PHON9 v+ v f" `A -71,�'K / o 1( _Qf- PSLLC. 119/m ZoIc) COMPANY NAM% clo APPLICANT NAME OFFICE PHONE - MAIUNG ADDRESS CITY, STATE, ZIP CELL PHONE RELATIONSWTO PROJECT ❑ Architect ❑ Tenant ❑ Agent ❑ Other FAX NUMBER { - NAIyIg e - 2,6-9 NAME .�erRCW 19.27.095. 11'C1-,qf I m7ta an is Phu project value exceeds $5,000 MAILING ADDRESS CITY, STATE, ZIP � PHONE 4 � - EXISTING USE PROPOSkD USE EXISTING ASSESSED/APPRAISED VALUE _ _ VALUE OF PRbPQSED WORK i$ ! g 7 r SPRINKLERED BUILDING? )(YES Cr NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE) PROVIDER ❑ LAHEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER 13 LAi ET-1AVEN ❑ HIGHLINE o PRI-VATS (SEPTIC) f PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING S . FT. PROPOSED S . FT. TOTAL S . FT. _ BASEMENT FIRST SECOND THIRD ADDITIONAL FLOORS,�)ESCRIBE) DECK (0 COVERED OR © UNCOVERED?) GARAGE 0 CARPORT 0 NUMBER OF FLOORS nQ°TDf o `rnoroeeo TOT,v, f i roreL rurrlhn ar rorm morosan Air "W'" sr "NEWHOMES ONLY" NUMBER OF BEDROOM ESTIMATED SELLING PRICE $ Indicate number of each type of fixture to be installed or relocated hs.part of this project. Do not include existing fixtures to remain. Value of Mechanical Work AIR HANDLING UNITS BBQS BOILERS COMPRESSORS/ DUCTS PLI 2MrNG (or Tub/shower Combo) DR[ NKING FOUNTAINS ELECTRIC WATER HEATERS HOSE BIBBS (A COPY OF BIDOR ESTIMATE EVAPORATIVE COOLERS FANS FIREPLACE INSERTS FURNACES GAS LOG SETS LAVS paffi oom shdA RAINWATER SYST SHOWERS SINKS SUMPS r BE INCLUDED WITH APPLICATION) GAS'PIPE OUTLETS WOODSTOVES GAs wivrtFt mi ATERS MISC (Describe) HOODS �comme ctelj RANGES REFRIG. SYSTEMS URINALS MISC (Describe) VACUUM BREAKERS WATER CLOSETS frouey WASHING MACHINES r C! r n�Y.r nt y f .sir, ♦/.matt am- tF- s _,^,'Jr or =1 th-cri: C4 •• a t r tl.= .. l.s.c. .sue . M_. ., - P- 1= a - r' F'-' 3 .g_ f , �i _:.y sw� sr. .�� :f::.o to . bsst .y knowledge, the Wormation submitted in support of this permit application is true and correct. I cart(N that I will comply with all applicable City of Federal Way regulations pertaining to the work authorized 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 attorneys' fers incurred in the Investigation and dWfense 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 supplied to the city as a part of this appitcation. / q SIGNATURE: and/or Authorised 10 7, r LJ a NEV o ADDITION a ALTERATION o REPAIR ❑ TENANT IMPROVEMENT BUILDING SHELL ONLY? a YES o NO BASIC PLAN? a YES o NO ZONING DESIGNATION CHANGE OF USE? o YES a NO NEW ADDRESS REQUIRED? o YES o NO UP/SEPA/SU? o YES o NO PLATTED LOT? ❑ YES o NO DEMO PERMIT REQUIRED? a YES a NO Bulletin #100 — January 1, 2008 Page 2 of 4 MandoutsTermit Application