20-101489-Building Permit Application-04-09-2020-V1PERMIT NUMBER 0— ` 1 01
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal 'fray, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenterCcityoffederalway.com
L j 9 { — — TARGET DATE
SITE ADDRESS
f`
SUITE/UNIT 0
j
C3 1 L. idA V y J' 0-7
I J
PROJECT VALUATION
ZONING
AS ESSOR'S TAX/PARC)tL
TYPE OF PERMIT
❑ BUILDING ❑ PLUN113ING 0 MECFIAmcAL ❑ DmOI,ITION Ll ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
PROJECT DESCRIPTION
Detailed description of work to
f e LLB- ' 6
be included on this permit only
'
NAME
PRIMARY PHONE
Z"S S-y o-
PROPERTY OWNER
MAU,ING ADDRESS f)
-
E-MAIL
CITY
STATE
�
ZIP 4j
-
NAME 1 - Q
PHONE .
r2-
LING ADDRESS
A -5, Z�� '
g pWL'
IF ,60da i2 �
CONTRACTOR
CITY STATE
ZIP
IF F T
FAX i
-'
WA STATE CONTRA4;TOR'S LICENSE #
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE #
ljd&s
%
NAME I/f� / /(-i-. ..
t ` L L.�
PRIMARY PHONEAoAt{� - .
�+`�d �� V4 f-� Y
APPLICANT.
MAILINGAIDDRE5S
E-M L
€� 4 c, "ej a bS �1d A),,Ce�
CITY
STATE
ZIP
FAX -`
'
J
PROJECT CONTACT
NAME ' A
�� _ �, 1 � .rt!
PRIMARY PHONE
p-�I �.C]� 6 1
MMLING ADDRUS
`_ f L s
EMAIL j "
14kel "L9j—lo / -I V
(The individual to receive and
respond to all correspondence
CITY
STATE
ZFP j
FAX
xrg
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,006 or more
' (RCE1I9.27:095)
MAILING- "DpRESS, CITY, STATE, ZIP
PRONE'
I certify under penalty of perjury that I am the p'ropertg owner or authorized agent of the propertg owner. I certify that to the vest
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 authorized by the issuance of a permit. I understand thatthe
issuance of this permit does not remove the owner's responsibility for compliance with focal, state, or federal Maws 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' fees incurred in
the invsstigaiion and rlefeiise of such claim), which may be made by any perso-ry including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its offYcers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
SIGNATURE:
41
PRINT NAME:
Bulletin #100 -January 29, 2016 Page I of 2 k:\HandoutsTennit Application
- -
VALUE OF AIECHAMCAL WORK
MECHANICAL PERMIT
Indicate how many of each type of flxture
to be installed or relocated as
art of this project. Do not include exdstlng ,res to remairL
® AIR HANDLING UNITS
FANS
GAS PIPE OUTLETS
OTHER (Describel
AIR CONDITIONER
FIREPLACE INSERTS
HOODS (comme,dal)
BOILERS
FURNACES
HOT WATER TANKS 1c�)
_
_ COMPRESSORS
GAS LOG SETS
REFRIGERATION SYST
-
DUCTING
GAS PIPING
WOODSTOVES
VALUE oPPLvmam�c Waxx
PLIJYMING PERMIT
Is
Indicate how many 2f each type o
ixture to be installed or relocated as
part 2f this jeLoject, Do not include existing res to remain.
BATHTUBS (or nm/snowucomuo)
LAVS (Hied snd�)
TOILETS -
-WATER PIPING
_- DISHWASHERS -
RAINWATER SYSTEMS
URINALS ,.
®_
OTHER(bescribe)
_ DRAINS
SHOWERS
VACUUM BREAKERS -'
_
DRINKING FOUNTAINS
SINKS (xdi �/uew'y)
WATER HEATERS (Eca;cl
-
HOSE HIBBS
SUMPS '
WASHING MACHINES
TOTAL FD:TUPFS
GENEI� AT, INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVEMENTS. -
EXISTING/PREVIOUS USE
LOT SIZE (In Squaze Feet)
EXISTING FIRE SPRINKLER SYSTEM?."
PROPOSED FIRE SUPPRESSION SYSTEM? -
❑ Yes ❑ No
❑ Yes ❑ No
RE3�EI®'TL4L = SEW OR 1�DDITION
.,AREA DESCRIPTION ;(in-sigUare feet)
EXISTING
-PROPOSED
- TOTAL
�; :'_,: ` � ' FOR OFFICE USE
BASEMENT-
FIRST FLOOR (or Mobile Home) . - _
s _ _ :.
_.__��.
f
;SECOND FLOOR
COVERED ENTRY
-
DECK
--
GARAGE ❑ CARPORT ❑-
- -
OTHER (describe)
.
.:'. -�- -.
.. ._ _,;...
Area Tot als
Eatsrmc
PaorosEor_.
snreL.
,,%
*FNEIVHOMES ONLY** _.
._..
... _ ...wr
_....... .-
-. -
E5T11t4ATED SELLING PRICE` "- --- ::<-#;OF BEDROOMS,
�OI1Il17ERCIAL, SEW%AI3DITION
..
ea in
Cons ruction-of�
#
AREA DESCRIPTION
- Occupancy Grolip(sj"
- :
"e
-
Information
S uaie Feet
,Additional
.Stories -
NEW BUILDING, U
- ADDITION
�p�17Vl�RCIAL-REMODE L/TENANT IMPROVEMENTS ,
AREA DESCRIPTION -
Area in
Occupancy Group(s)
Construction
of
- n
sl
Additional Information
Square Feet.
a
Stories
TOTAL BUILDING
TENANT AREA ONLY
-
PROJEOT AREA ONLY
'Bulletinttl00'=lanuary29;'2016 Paget oft ,'.r-.Tc:mdoutsxremutAroollcaHon