20-103150-Building Permit Application-08-20-2020-V14ik
CITY OF
Federal Way
PERffiT NumBER
PERMIT APPLICATION
PERMIT CENTER + 33325 8th Avenue South + Federal Wady, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcentet@cityoffederalway.com
TARGET DATE
SITE ADLIREBS
SUITE/UNIT •
4--1a(? su) .3150,E sT 1 d nr.l Xt 9 0.,23
�v
PROJECT VALUATION
ZONING
ASSESSOR'S TAXIPARCEL
9s, vvo . vv
8 7 3 l 9 q-
0_g L D
TYPE OF PERMIT
P(BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION 1:1 ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
P e
Mac A-er -
PROJECT DESCRIPTIQN
,
Detailed description of work to
I4 e1) l7
be included on this permit only
NAME
Marc J.�q�h�rirk AWffe
PRIMARY PHONE
��0-q-9p•- Cll
PROPERTY OWNER
£-MAIL
/c
LING ADDRESS
3,2f1k) 3AIM sY
R
CITY ! STATE ZIP
17I/J oC]
NAME n f L r l 've f fr'/]P'TII S '° l G
[� (fY+ fI�
PHONE J
MAILING ADDRESS
7 lJ a
CONTRACTOR
CS G j TATE
�7Q Gar ,IJ71
ZIP '3 o �
PAX
WA fiTATE CO RACTDR'aS LICENSE 40
EXPIRATION DATE
,a
17RI ■
1�10 ,1 3 q�'l 7 7
NAME
PRIMARY PHONE -
AMICANT
DIALLING ADDRESS
E-HAIL
CITY
STATE I
ZIP
FAX
(FAME r C
iI� �✓�7 Q!}
PRISIAHY PHONE
PROJECT CONTACT
N•
MAILING ADDRESS �7
r � �-+
A4)&19 o-p Al vd #e �.-? C)
E-MAIL
t7he individual to receive and
respond to all correspondence
L��
CrrY
CR2"06
STATE
Cfl
ZIP
W303
FAX
concerning this application)
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When Valise is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
iRC W } 9.27-0951
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
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 authorised by the issuance of a permit. I understand that the
Issuance of this permit does not remove the owner's responsibility for compliance urith local, state,
or federal laws regulating
construction or environmental laws.
Ijeirther agree to hot harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees Incurred In
the investigation and ease of
such claim), which may be made by any person, Including the undersigned, and filed against the city,
but only where such m arises
out of the reliance of the city, Including its officers and employees, upon the accuracy of the
information supplied a city as a part of this application.
SIGNATURE:/�
DATE
���!CIr►'
PRINT NAME:
Y,
Bulletin #100 —February 19, 2020 Paige I of 2 kAHandoutsTermit Application
MECHANICAL PERMIT
VAGUE OF MECHANKAL WORK
Indicate how o each f o
re to be itiatalled or reloacted W, por
of this pmied. Do not include coratiftdue. to remain.
_ AIR HANDLING UNITS
I FANS
GAS PIPE OUTLETS
OTHER (Oexnbel
_ AIR CONDITIONER
FIREPLACE INSERTS
HOODSa ,,
_ BOILERS
FURNACES
HOT WATER TANKS Iqp
_ COMPRESSORS
GAS LOG SETS
REFRIGERATION SYET
DUCTING
GAS PIPING
WOODSTOVES
PLUMBING PERMIT
VAWE OF PLUMBPRO WORK
$
f cute haw MaM o each tYPe o to be iostalled or reloonted Wa
pof o this E2jact. Do not include s to remain
_ BATHTUBS WVS,a—aabl
_ DISHWASHERS _ RAINWATER SYSTEMS
Z DRAINS _ SHOWERS
_ DRINKING FOUNTAINS _ SILKS Iaw.,aae
HOSE RIESS SUMPS
TOILETS WATER PHnNO
URINALS OTHER (Deacnlc)
VACUUM BREAKERS
WATER HEATERS (o. ac
WASHING MACHINES TOTAL PeT'OREB
GENERAL INFORMATION
CIIITIGLAPGeos eROeinl'tp
WAieA flaonnat t
BBW6R Ptuounoa
v.VAn Oe EtUa MROVEYEIITB
merma/remooe aeE
LOTnu a•en�. r.eg
sverwa rwe eesww.eR eaF`e,ty
❑ Yes o No
eaoroaso rms noeearewos eTetSRa
❑ Yes O No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (In Square feet)
EXISTING
PROPOBED
TOTAL
FOR OFFICE DBE
13ASEMENT
FIRST FLOOR (or Mobde Home)
SECOND FLOOR
COVERED ENTRY
DECK
GARAGE ❑ CARPORT ❑
OTHER (describe)
Area Totals
••NEW RGICES
OM.P••
ESTIMATED SELLING PRICE S
p OF BEDROOMS
COMMERCIAL — NEW/ADDITION
AREA DEBCRBPTION
Arse vare Fee[
Occupancy an up(E)
Con.Hon
TV..
a
Stories
Addltfonal Infor ,tion
NSW Bunaan
ADORIOR
COMMERCIAL— REMODEUTENANT IMPROVEMENTS
AREA DESCRIMON
A as L.
Feet
Occupancy Grougel
ConatrucHoa
I of
B[orW
Additlonal Infirmativv
TOTAL EMB
TENANT AREA ORRT
PROJEIT AREA T
Bulletin k100-Febnwy 19, 2020 Page 2 of2 k:\Handouts\Permit Application