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20-102368-Building Permit Application-06-17-2020-V141k CITY OF - Federal Way PERMIT NUMBER PERMIT APPLICATION PERMIT CENTER + 33325 8th Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + permitcenter@cityoffederalway.com - TARGET DATE SITE ADDRESS 1-z60) roc - �I c s . e-der d too , 40'q0,03 SUITE/UNIT # PROJECT VALUATION 210NING ASSESSOR'S TAX/PARCEL # TYPE OF PERMIT X BUILDING 'W PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT 1 1^ a !� VA o t- e i P e � PROJECT DESCRIPTION Ad � Tyi a . N� .' e1� 6 e 471q viol n I ck - Detailed description of work to be included on this permit only 11 .0 )-PL-ab e 5 ,U C� A Le �(a ^ e i ki- l n l / . y _ �� I°1IPPfINARY NAME Dailr PHONE �' 02 PROPERTY OWNER MAILING ADDRESS CITY (� {� ��?�S�TgATE '°� alei ZIPV NAME PHONE MAILING ADDRESS E-MAIL CONTRACTOR CITY STATE ZIP FAX WA STATE CONTRACTOR'S LICENSE # EXPIRATION DATE UBI # NAME QOfl 1� Vl PRIMARY PHONE ,3 - 0 - APPLICANT MAILING TS E-MAIL CITY .Y0i wV�Tg ZIP W _ //T FAX PROJECT CONTACT NAME � 0 �� r� , PRIMARY PHONE Zt --,TA I — � ✓� � (The individual to receive and respond to all correspondence MAILING ODDRESS ©k C, )' E-MAIL concerning this application) CITY jy/ i STATE ZIP �} !f o FAy FINANCING PNAMEPROJECT OWNER -FINANCED When value is $5,000 ormore (RCW 19.27.095J G ADDRESS, CITY, STATE, ZIP PHONE 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 as apart of this application. SIGNATURE: .I DATE 0.6 PRINT NAME: Ali to Bulletin 4100 —February 19, 2020 Page 1 of 2 k:\Handouts\Permit Application MECHANICAL PERMIT Indicate how many of each tt/pi AIR HANDLING UNITS AIR CONDITIONER BOILERS COMPRESSORS DUCTING PLUMBING PERMIT Indicate how many of each typ BATHTUBS (o Tub/shower Combo) DISHWASHERS DRAINS DRINKING FOUNTAINS HOSE BIBBS F fixture to be installed or re, FANS FIREPLACE INSERTS FURNACES GAS LOG SETS GAS PIPING Ffixture to be installed or relocated LAVS (Hand sinks) RAINWATER SYSTEMS n SHOWERS SINKS ptchen/utiiity) SUMPS VALUE OF MECHANICAL WORK as part of this project. Do not include existing Ixtures to remain. GAS PIPE OUTLETS OTHER (Describe) HOODS (commerolat) HOT WATER TANKS (Gas) REFRIGERATION SYST WOODSTOVES VALUE OF PLUMBING WORK $ >f this project. Do not include existing firdlres m remain TOILETS URINALS VACUUM BREAKERS WATER HEATERS (Eiectric) WASHING MACHINES WATER PIPING OTHER (Describe) GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF EXISTING IMPROVEMENTS EXISTING/PREVIOUS USE LOT SIZE (In Square Feet) EXISTING FIRE SPRINKLER SYSTEM? PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes ❑ No ❑ Yes ❑ No RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOR COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER (describe) Area Totals EXISTING PROPOSED TOTAL. **NEW HOMES ONLY** ESTIMATED SELLING PRICE $ # OF BEDROOMS FOR OFFICE USE COMMERCIAL - NE ADDITI AREA DESCRIPTION ea m Square Feetype Occupancy Group(s) Construction Stories Additional Information NEW BUILDING ADDITION ® A-2- Type COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area in SonarFeet Occupancy Group(s) Construction a # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 — February 19, 2020 Page 2 of 2 k:\Handouts\Pernut Application