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07-100847dryer RECEi�JSp Dl•--LL Federal Way PERMIT coMM6,ulurrDWOMENTSERVICL S �• �a7 SF MF CO ME EL PL DE EN FP 39325 Am FEDERAL WAY,VE WA PS PO BOX 9718 ARPLI CATI O N FeneRAi. WAY, WA aspra•sras �'��//�) / ',l53-935•$507� FA%R53.89Ir�¢�. K�� l b ww+u.cltwlrsdrmlwey,ov(nr• (1� iBUI OF DEFT, The following is re uired igformiation-anincemLDlete aigglication will not be accepted. Please printIggOW0 ink) or t • p RTY INFORMATION SITE ADDRESS _3 (_4a_I 1 2O 1 Ir••1 AtlL •J o iAj-',j �y SUITE/UNIT Y ASSESSOR'S TAB/PARCEL M d 1 2. 1 Q'cj - g =l { LOT SIZE (sfi 9 2-9 LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1) uaaa, --p-10 ~f- Lewuw k9W 11mr0d.0 TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING -PI FIRE PREVENTION SYSTEM PROJECT DESCRIPTION (Provide detailed description of work included on this permit oniul c 5 L,4 Fe, r, i:LEv VK IO - O J PROJECT NAME (Name of Business or Owner Last Name) PEOPLE•• • PROPERTY OWNER CONTRACTOR ml� APPLICANT NAME PRIMARY PHONE 0 R Wes ; •T2 L r-1 g MAILING ADDRESS CnY. STATE, ZIP 1 O 9 (2 cRF-s •D(;. S- COMPANY NAME �( ©pEZ,1 APPLICANT NAME � �LE%0 OFFICE PHONE (204) - 0311 (jE C- lDALE. -67.3 MAILING ADDRESS po aoY 585z8 CrLY, SPATE. ZIP IUKwtLA QA q$1:59 CELL PHONE ( ) - CrIY OF FEDERAL, WAY BUSINESS LICENSE NUMBER EXPIRAmoR DATE ( -a -� o -2 a �-B 12. / 61 /or7 FAX NUMBER (Z53).9 72 -/7/R0 _Z L CONTRACTOR'S REGISTRATMON NUMBER (copy of card required with each application) EXPIRAMON DATE / / I: t 1? CO 1 * O C1 q K\/ 5 16 Q 7 COMPANY NAME E oNC mac, APPLICANT NAME 'DALE A<LEi-�l OFFICE PHONE ( W6)_57s-0311 MASI.rNG ADDRESS 'po Qiox 2 $ CrIY, STATE, ZIP QA 9 813'G CELL PHONE [ ) - .58-- tL.r WIC RELATIONSHIP TO PROJECT ^ ❑ Architect ❑ Tenant ❑ Agent P9 Other (Describe) OOTRRC-VQ SL FAX NUMBER. (Z53) 8 2 - 759 a CONTACT NAME 1l PRIMARY PHONE E ADD 1�At-E f1LE�►J (206 )5r%J , - e LENDER EXISTING USE - M C rr- L PROPOSED USE aTE L i EXISTING ASSESSED/APPRAISED VALUE $ VALUE OF PROPOSED WORK $ 5 Ll / O _ 6 Q SPRINKLERED BUILDING? )<YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ❑ NO WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ FIIGHLINE ❑ TACOMA ❑ PRIVATE (WELL) SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC) PROJECT FLOOR AREAS AREA DESCRIPTION EXISTING S1. FT. PROPOSED S . FT. TOTAL BASEMENT FIRST SECOND THIRD FOURTH ADDITIONAL FLOORS (DESCRIBE) DECK (COVERED?) GARAGE ❑ CARPORT ❑ NUMBER OF FLOORS ZUSTM Faoroem TOTAL A1(-+ st ti �� `usa v araraarcwxo ar OF ,.. � sor u sr "•NEW HOMES ONLY" NUMBER OF BEDROOMS ESTIMATED SELLING PRICE $ _ Indicate number of each type offixture ixture to be &wtaIied or relocated as part of this project Do not Include existing JNtures to remain Value of Mechanical Work AIR HANDLING UNITS EVAPORATIVE COOLERS GAS LOGS REFRIG. SYSTEMS BBQS FANS HOODS )Commmam) WOODSTOVES BOILERS FIREPLACE INSERTS RANGES MISC (Describe) COMPRESSORS FURNACES GAS WATER HEATERS DUCTS GAS PIPE OUTLETS BATHTUBS (a Tub/Shower Combo) SHOWERS WATER CLOSETS nv" MISC (Describe) DISHWASHERS SINKS DRINKING FOUNTAINS GAS PIPE OUTLETS SUMPS RAINWATER SYST WASHING MACHINES URINALS HOSE BIBBS LAVS JEuu„oom si„kil VACUUM BREAKERS ELECTRIC WATER HEATERS I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold harmless the City qr Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred In the investigation and defense of such claLW, which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim arises out of the reliance of the city, including its gUIcers and employees, upon the accuracy of the information supplied to the city as a part of this application. . -1 1 - NAME/TITLE A 61f- DATE Z - I Z- O'7 RELATIONSHIP TO PROJECT ❑ Owner ❑ Agent ❑ Contractor o Architect ❑ wti,• B ","'" O Ii ivrrivi"Iiliiriorlrra`iIix�aivn'TENANT iavEa�:q�r;, Bi1Ii.DIi�i_4 BFAEI:l.".O}ItiY'ii'-.:iYEB--�S1Vfl►Af3IC`Ye'iAug?,,r��+s:�'�#+ : :'-'_ '. d'�:.' c NO 7.(?NA�4I]EBIGiNA3'UT�.cp`rG�ik�r''* iCi°IIiQE`bl?;ii19LT '''''.= ''.:- = uYES NO iV1AI3ARE59 RUIREI!? '=G+Yssp"):rfo.,UPft3EP11/BUztr-' ,:; ❑ YES D NO piATTE `x:QS'7 rz':tR : ki"; ti o YEl9. ;[i I!IU ..ra ( Ls .UEAdU' fdttEt7•'-?No -' . YLg A Bulletin #100 - January 7, 2005 Page 2 of 4 MHandoutsTermit Application