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20-103259-Building Permit ApplicationC { ��r Federal ed € Way CITY OF PERMIT APPLICATION PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com PERMIT NUMBER _ �- TARGET DATE SITE AbDREBS 2-r! 6 / -5, s , ! �, f SUITE/UNIT i PROJECT VALUATION TYPE OF PERMIT NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to be included on this permit only PROPERTY OWNER CONTRACTOR APPLICANT• PROJECT CONTACT (The individual to receive and respond to all correspondence concerning this application) PROJECT FINANCING When value is $5, pop or more (RCW 19,27.095) V - -_ L `'()_rL•� — / 07 fNCi ASSESSOR'S TAX/PARCEL ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL 11 DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME MAILING ADDRESS 46 1�7— CITY WA STATE CONTRACTOR'S LICENSE S I^rI 9 zk L NAME�g�SJ AILING ADDRESS CITY NAME` MAILING CITY NAM MAILING ADDRESS, CITY, STATE, Zip ZIP PR1i44ARY PRONE '? s'l, kq PHONE ry FWAM FAX EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 6 PRIMARY PHONE 2-%3.-z "fin t'PJ t ZIP FAX PRIMARY PHONE. E MAIL i STATE ZIP FAX QA 1� 2 cd © OWNER -FINANCED PHONE I certfy 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* permit. I understand that the issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal Taws 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 investigation and defense of such claim), which may be made by any person, including the undersigned, and flied 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 apart of this application. SIGNATURE. ter- tI/ DATE Z PRINT NAME:I fJ �/i %��/�i i>n Bulletin #100 -January 29, 2016 Page I of 2 k:lHandoutslPermit Application MECHANICAL PERMIT VALUE OF MECHANICAL WORK Indicate how man o each t e o re to be Installed or relocated as art o thls ro ect. Do not uu:de exis ® A X HANDLING UNITS FANS res to rem _� AIR CONDITIONER _� GAS PIPE OUTLETS OTHER (Describe) FIREPLACE INSERTS HOODS (cow., 4 ® BOILERS _- FURNACES COMPRESSORS HOT WATER TANK31oaq GAS LOG SETS REFRIGERATION SYST —_ DUCTING GAS PIPING yg�q WOODSTOVES PLUMBING PERMIT VALUE OF PLUMBING WORK Indicate how many of each Ly2e o re to be installed or relocated as part of Gusi ro ect. Do not include exist' res to remc __ BATHTUBS la: nm/Sin ,comsq LAVS ixo„a ss„xo�_ TOILETS DISHWASHERS __ RAINWATER Ss) MS . WATER PIPING __ DRAINS . URINALS __ OTHER (Describe) SHOWERS ® VACUUM BREAKERS ® DRINKING FOUNTAINS HOSE BIBBS SINKS (jct&�/Uoty) ® WATER HEATERS (Etom;q SUMPS WASHING MACHINES � TOTAL FIXTURES GENERAL INFORMATION CRITICALAREAS ON PROPERTY? I -------- --� I wt nl3e iIu 8quue Feet) I BAISTnfG FIRE BPRDiELER SYETEffi1 PROPOSED FIRE SVPPRE39ION ❑ Yes ❑ No ❑ Yes ❑ No RESIDENTIAL e NEW OR ADDITION AREA DESCRD'TION (in square feet) EXISTING PROPOSED;TOTALFOR OFFICE USE BASEMENTFIRST FLOOR (or Mobile Home),,�. SECOND FLOOR COVERED ENTRY GARAGE ❑ CARPORT ❑ OTHER (describe) Area Totals msrixo PROM"a rau �OMMERCIAI-JNEW/ADDITION AREA DESCRIPTION Area i° Construction # og S uare Feat Occupancy Groups) Additional information e Stories ENEW BUILDING.: ADDITION COMMERCIAL - REMODEUTENANT IMPROVEMENTS AREA DESCRIPTION Area is Coasteuctioa 8 of Square Feet Occupancy Groups) Additional Information mrnl RrR.,m„ a _. Stories TENANT AREA ONLY Bulletin #] 00—Ianuaty 29, 2016 Page 2 of 2 k:�Handouts�Permit Application