20-102186-Building Permit Application-07-17-2020-V141k
CITY OF
Federal Way
PERMIT NUMBER Gam0
PERMIT APPLICATION
PEIMT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325
253-835-2607 + FAX 253-835-2609 + permitcenter�cityoffederalway.corn.
IOZ.100-
--- -- —� TARGET DATE ASAP
SITE ADDRBSS
SUITE/UNIT 0
PROJECT VALUATIOX
ZONING
ASSESSORS TAX/PARCEL 8
$
o z
TYPE OF PERMIT
❑ BUILDING g PLUMBING X MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
M OlzAue5 1 ,§r GLocS.- REMOPEL
PROJECT DESCRIPTION
L} tdAe eio to d I n i Art -IL o f oir a n 45 eat.
[ 04 n
Detailed description of work to
be included on this permit only
{ 5 L !
NAME
gfiVF-CN t WAI,-a MWZ L6
PRIMARY PHONE
253. 50$.21Z5
PROPERTY OWNER
KA ING ADDRESS
3 ICU 3'14k Ave 5 W
E-MAIL
wakes �0 W WQ h.
CITY
P�_Vc?-ft WAY
STATE
W,.
ZEP
�i rJ3
NAMI. Tlk-60 B �l�Lyft s al i �V Nonti I m�
PHONE
2Ob . 303. 3Z Bit
MAII.IN6 ADDRESS�`I�! i 4 "
'3 4�1 fy T .s �
E-MALL
S E N vz oyAwa.
CONTRACTOR
CITY r,em W"
I��CT/ilt/l f � 7
S'T-A/T/E_
yY 1'�
ZIP
FAX
WA STATE CONTRACTORS LECEnsE S
n4bm 1$45610
EXPIRATION DATE
ti/A/20
USE i
coo 0151 S Z
NAME �f �] ,,+ ,- t (�,� �/� �� �j f
f?-Ql IV f YV1'� A Iiwlt-'I a
PRIMARY PHONE] �j
Z�j3,bCU,f,15
MAILING ADDRESS
31 5211 3� T" (1I� 5UJ
E-MAIL
alz-� P d.h
APPLICANT
CITY f1Mt I' W XI
STA'
!`
ZIP 1502,3
FAX
PROJECT CONTACT
NAB
Y�f f 1 Y I b� �7
PRIMARY PHONE
Gj �j �i ZS
(The individual to receive and
respond to all correspondence
TRAILING ADDRESS
c dA-rP ' e__,
r MAIL
CITY
s2ArE
z[P
VAX
concerning this application)
PROJECT FINANCING
NAMES
OWNER FINANCED
When value is $5, OOP or more
(RCW 19.27X95)
MAILING 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 Spay 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 r city as a part of this application.
SIGNATURE: DATE r7.0 T2�O
PRINT NAME:�lZ�c�
Bulletin #100 —February 19, 2020 Page 1 of 2 kAHandoutslPerrnit Application
MECHANICAL PERMIT VALUE OF MECHANICAL WORK
$
Indicate how T"y 9f each e of fbcture to be installed or relocated as part of this project. Do not include existingf&wres to remain.
AIR HANDLING UNITS FANS Z GAS PIPE OUTLETS OTHER (Describe}
AIR CONDITIONER FIREPLACE INSERTS HOODS (conm ,6w)
BOILERS FURNACES HOT WATER TANKS (cam)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
VALUE OF PLUMBING WORK
�
Indicate how many o each qee offtxWre
to be installed or relocated as
part o this project. Do not include existingfixtures to remain.
BATHTUBS (or Tub/SMa Comb.)
LAYS (He C Sinks)
TOILETS
J_ WATER PIPING
DISHWASHERS
RAINWATER SYSTEMS
URINALS
OTHER (Describe)
DRAINS
SHOWERS
VACUUM BREAKERS
DRINKING FOUNTAINS
I SINKS (xicnt,en/Utjiiry)
WATER HEATERS (nevi.)
HOSE BIBBS
SUMPS
WASHING MACHINES
TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PORVEYOR
SEWER PURVEYOR
VALUE OF EXISTING IMPROVrMENTS
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE SPRINKLER SYSTEM?
PROPOSED FIRS SUPPRESSION SYSTEM?
Yes No
L Yes gI,&
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL FOR OFFICE USE
--- .....................................................................................
BASEMENT
-......................................... ...
FIRST FLOOR (or Mobile Home)
....................................... .......................
SECOND FLOOR
.................... -- -----....-.............,.,,........
COVERED ENTRY
....................................................................
DECK
.................................... .............................. ...... ..........................
......_.._.....,.,,.,
GARAGE ❑ CARPORT
OTHER (describe)
a.^.LISTMG PROPOS®
Area Totals
**NEW HOMES OIVLY**
ESTIMATED SELLING PRICE $ # OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area In
5 uare Feet
Occupancy Group(s)
Construction
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT IMPROVEMENTS
AREA DESCRIPTION
Area In
Square FeetType
Occupancy Group(s)
Construction
of Stories
Additional Information
TOTAL BUII,DIxe
TENANT AREA ONLY
PROJECT AREA ONLY
Bulletin #100 — February 19, 2020 Page 2 of 2 k-ll3andoutsTerrnit Application