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20-105046-Building Permit Application-12-31-2020-V1
41k CITY OF Federal Way PERMIT NUMBER PERMIT APPLICATION PERMIT CENTER + 33325 811> Avenue South + Federal Way, WA 98003-6325 253-835-2607 + FAX 253-835-2609 + pensniteenteKi cityofl'ederalway.cam TARGET DATE SITE ADDRESS SUITE/UNIT A ET- ct bvne>-�) "IA�' PROJECT VALUATIONM ZONINN ASSESSOIR'S TAX/PARCEL R TYPE OF PERMIT )(BUILDING Xi PLUMBING )<MECHANICAL ❑ DEMOLITION ❑ ENGiNEERING ❑ FIRE PREVENTION NAME OF PROJECT ! G N L` ,r H U N T I! 6C')W 4 E fi• , Q O!J AN V PROJECT DESCRIPTION 1fA��7 Ann, Nr Detailed description of work to ti be included on this permit only NAME l,A P MARY PHONE 1F J S MAILING ADDRESS MAIL �M PROPERTY OWNER CITY 4STATE ZIP NAME � � HONE 65 4 MAILI GAD RESS `1 �7T E. L GO "CI1 1 L �• CONTRACTOR CITY 407I I STATE ZIP � � FAX WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE UBI # a NAM ^ �]L3 , - i +-� P MARY PHONE -tom 9 5 �� MAILING ADDRESS r7 q i EMAIL F • L+OITi APPLICANT CITY I SSA STAT ZIP 86 1,1 NAME �' ` I r PRIMARY PHONE PROJECT CONTACT 1 MAILING ADD SS E-MAIL (The individual to receive and respond to all correspondence CITY STATE ZIP FAX concerning this application) PROJECT FINANCING NAME � OWNER FINANCED When value is $5,000 or more MAILING ADDRESS, CITY, STATE, ZIP PHONE (RCW 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 jlled 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 a part of this application. SIGNATURE: ' DATE PRINT NAME: Bulletin 4100 — February 19, 2020 Page I of 2 k:\HandoutslPermit Application VALUE OFMECHAMCAL WORK MECHANICAL PERMIT $ (;j , ewtc% �, Indicate how many of each type of Inxture to be msrauea- AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS _ HOODS jc..mr ) _ BOILERS FURNACES HOT WATER TANKS ic. ) COMPRESSORS GAS LOG SETS _ REFRIGERATION SYST T DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT VALUE OFPLUMB/NG WORK $ Za 1AX=I. 7 Indicate how manM of each e o ccture to be installed or relocated as art o this ro'eet. Do not include exis ' in fixtures to remain. _yp BATHTUBS (arnb/Shm..rc.mh.j LAVS IH..esi.t.) TOILETS WATER PIPING _ DISHWASHERS RAINWATER SYSTEMS _� URINALS OTHER (Describe) �I DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS IM.tt ./Uiw.Pl WATER HEATERS (©.. iq HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? µ A WATER PURVEYOR 1�AK-6RW r/P SEWER PURVEYOR LAwt A;:-'1Ct" VALUE OF SRiSTDVGIMPROVEMENTS $ =S!r1 NG/PREVIOUS USE LOT SIZE (In Sqa Feet) EXISTING FUZE SPRINKLER SYSTEM? ❑Yes)(No PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes xNo RESIDENTIAL - NEW OR ADCDJITIOCNJ 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) ............................ _... _............................ ..-....................................................... Area Totals EMSTIRG PROMSEU TOTAL --NEW HOMES ONLY* - ESTIMATED SELLING PRICE $ 1 # OF BEDROOMS COMMERCIAL - NEW/ADDITION AREA DESCRIPTION ArB8 is Square Feet Occupancy Groups) Construction a # of Stories ion Additional Information NEw BUILDING ADDITION COMMERCIAL - REMODEUTENANT IMPROVEMENTS AREA DESCRIPTION Area in Square Feet Occupancy Groupla) Construction a # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 - February 19, 2020 Page 2 of 2 k:UHandouts\Petmit Application