20-101529-Building Permit Application-04-09-2020-V14illkk
t:iYV or: :�. PERMIT .,. APPLICATION
Federal Way PERMIT CENTER + 33325 811 Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + ermitcenterTifcirvoffederai%vay.com
PERMIT NUMBER _
—-- -- � TARGET DATE
SITE ADDRESS SU[TEIUNIT e
27
PRO.IECT VALUATION ZONING ASSESSOR'S TAXIPARCEL
$ 7�kC, ".s7rZ 7-5 7 f- 6
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING 1:1 F)RE PREVENT1pY
NAME OF PROJECT —1-he
PROJECT DESCRIPTION J ��
Detailed description of work to .h A7,--1 /u!
be included on this permit only % �, ��" / ■ ./ w
NAME ��..
II���
14
PRIMARY PHONE
PROPERTY OWNER
MAILING ADDRESS
E-MAIL
II —
Uip 'MJ,v r�o
CITY
oCer CeJ
STATE ZIP
OD,-2
NAME
b
PHONE
MAILING ADDRESS
n,
E-MAIL
CONTRACTOR
CITY
STATE ZIP
FAX
WA STATE CONTRACTOR'S LICENSE ■
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE 0
I I
f�NAME
,WD�
PRIMARY PHONE
APPLICANT`
MAILING ADDRESS
E-MAIL
CITY
STAT ZIP
pt cf y
FAx
PROJECT CONTACT
NAME
PRIMARY PHONE
(The individual to receive and
respond to rill correspondence
MAILING ADDRESS
0 / C'
�
�� Y }r//
�
-
EMAIL
concerning this application)
CITY �F,, �
C
s E xIP
PAx
PROJECT FINANCING
NAME
When value [5 $S,i][l0 ormore
MAILING ADDRESS, CITY, STATE, ZIP
❑ OWNER -FINANCED
IRCII' 19.2ZO95)
PHONE
r certify under penalty of perjury that I am the property owner or authorised 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 cert(ry that I will comply with
at 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 fvr cvmpllance with focal, 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 fled 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
infarmation supplied to the city as a part of this application.
SIGNATURE;
_ DATE
PRINT NAME: .t '-- z'
Bulletin 4100-January 29, 2016 Page [ of k:lliandotttslPermil Application
MECHANICAL PERMIT
VALUE OF MECHAMCAL WORK
$ p
Indicate how MEW o each We afledIme
to be installed or relocated as
arta this ro'ecf. JM rot include vasyngfoprw to renwin.
AIR HANDLING UNITS
L FANS
GAS PIPE OUTLETS
OTHER (Describe)
— AIR CONDITIONER
FIREPLACE INSERTS
HOODSpe.ow.e°I
�GIE�(r Cj'
ORE
FURNACES
HOT WATER TAN KS p.q
4.,d
C
COMPRESSORS
RESSORS
DUCTING
GAS LOG SETS
REFRIGERATION SYST
GAS PIPING
WOOMOVES
PLUMBING PERMIT
VALUE OFPLUMBINO
WORK $ �ZK
fndicate hvw nwn o each o LYntre to be vLstdled or refomted as art. this ro'ecl. Do not include erisfin lures to remain
_ BATHTUBS yne/aro... o.»,ea LAVsa,.I l —/ TOILEIE WATER PIPING
_L DISHWASHERS _ RAINWATER SYSTEMS URINALS OTHER(Oescnbel
_ DRAINS _ SHOWERS VACUUM BREAKERS
_ DRINKING FOUNTAINS Z SINKS WATER HEATERS In.mq
NOES BIBBS SUMPS WASHING MACBINES TOTAL FRTURES
GENERAL INFORMATION
aRR1CAAARFA80x PROPERTY'!
WATER PURVEYOR
FLN�//iy
6aW6Re YEVOR
VALUE OF aASTMG asuROWNERTS
mf�sTmO/eRmova Oa/e
LOTSMZPnayu..e Y..V
rj C�7 `( ,
"o rtxE sewxw.r.R arerex>
❑Yes kNo
PROeosen Fnw eueeeeaalOx ararexv
0Yes X'No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION lin square feet)
EEISTIIiG
PROPOSED
TOTAL
FOR OFFICE USE
BASEMENT
�s
Q OS
FIRST FLOOR (or Mobde Home)
rfit
75-0
SECOND FLOOR
N
C�7�
COVERED ENTRY
DECK
GARAGE �2 CARPORT ❑
OTHER (describe)
Area Totals
65
'NEW HOA(ES ONLY"'
ESTIMATED SELLING PRICE $ a OF BEDROOMS
COMMERCIAL—NEW/ADDITION /
AREA DESCRIPTION
�B°
uve Feet
Occupancy Groups)
ConstruMion
Y of
Storlea
pddit onal Infonaeation
NEW BoaDIKO
ADDITION
COMMERCIAL—REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
9 ere Feet
Occupancy Grou Ple)
Construction
a
d of
Storks
Additional Information
TOTAL BUILDING
TENANT AREA ORLY
PROJBCT.AREA ORLY
Bulletin #100 -January 29,2016 Page 2 of2 kGHandoutsTennit Applicatian