21-100866-SF-Building Permit Application-03-19-2021-V1AIIi;k
CITY OF
Federal Way
PERMIT NUMBER
PERMIT APPLICATION
PERMIT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ 4,200.
_
TYPE OF PERMIT
® BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
CAROLINE PRICE CONCRETE RAMP PROJECT
PROJECT DESCRIPTION
Detailed description of work to
IDENTIFING EXISTING CONCRETE RAMP @ A TOTAL OF 109 SQ FT INCLUDING LANDING AAN
RAMPS
be included on this permit only
NAME
PRIMARY PHONE
CAROLINE PRICE
253-886-3161
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
30017 13TH AVE SOUTH
kariuld.wakaca@gmail.com
CITY
STATE
ZIP
FEDERAL WAY
OVA
NAME
PHONE
HOME OWNER
253-886-3161
MAILING ADDRESS
E-MAIL
30017 13th AVE SOUTH
kariukimakacaftamil.com
CONTRACTOR
CITY
FEDERAL WAY
STATE
WA
ZIP
98003
FAX
WA STATE CONTRACTOR'S LICENSE #
EXPIRATION DATE
UBI #
NAME
PRIMARY PHONE
CAROLINE PRICE
253-886-3161
APPLICANT
MAILING ADDRESS
30017 13TH AVE SOUTH
E-MAIL
KARIUKLWAKACACGMAIL.COM
CITY
STATE
ZIP
FAX
FEDERAL WAY
WA
98003
NAME
PRIMARY PHONE
PROJECT CONTACT
CAROLINE PRICE
MAILING ADDRESS
30017 13TH AVE SOUTH
E-MAIL
(The individual to receive and
respond to all correspondence
CITY
STATE
ZIP
FAX
concerning this application)
FEDERAL WAY
WA
98003
PROJECT FINANCING
NAME
® OWNER -FINANCED
When value is $5, 000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
IRCW 19.27.095)
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 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' fees incurred in
the investigation and defense 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 asap t o plication.
SIGNATURE: DATE 3/12/2021
PRINT NAME: CAROLINE PRICE
Bulletin # 100 — February 19, 2020 Pagel of 2 k:\Iandouts\Permit Application