20-103034-Building Permit Application-08-04-2020-V1CITY 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 + permitcentera-cityoffederalway.com
TARGET DATE
SITE ADDRESS
SUITE/UNIT #
29SIS Sw Ae Sw
PROJECT VALUATION
ZONING
ASSESSOR'S TAX/PARCEL #
$ V-�A
1 2 L) s 3 2- Q o -0
TYPE OF PERMIT
BUILDING ❑ PLUMBING ❑ MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
Deck -pep 1 otce� ��
"e ow clecL a.I::4- 6ui ld. W ; A ►
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME
5(P l DeleCs
PRIMARY PHONE
?0G - 3os1CsyS
MAILING ADDRESS
Z9A I S 3W kip Sw
E-MAIL
PROPERTY OWNER
CITY
k8ecoa1 Q
STATE
WA-
ZIP
g8oz3
NAME��O
PHONE
MAILING ADDRESS
2 � 27 5 3�1
E-MAIL
a"l % lay ltiao. 1
CONTRACTOR
CITY ^' 11 .,,1
STATE
WA
Z�yIP
FAX
P,LY'��' W
I"(Od
WA SACTORA LICENSE #
j"T IZ�i� 4 A 3/U/
EXPIRATION DATE
/0
UBI #
NA E tt__
p;
PRIMARY PHONE
2�3_ 952- S-Z33
atAj i1a, CV
MAILING ADDRESS
1627S y y
E-MAIL
i 0t bUp q (.t pb,C > 1
APPLICANT
CI
1L1 W
STAT
ZIP
el- ,/ �/ e)&
FAX
NAME
PRIMARY PHONE
PROJECT CONTACT
SAYS )-,h
MAILING ADDRESS
E-MAIL
(The individual to receive and
respond to all correspondence
concerning this application)
CITY
STATE
ZIP
FAX
PROJECT FINANCING
NAME
❑ OWNER -FINANCED
When value is $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW ] 9.27.095)
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
in of this application is true and correct. I certify that I will comply with
of my knowledge, the information submitted support permit
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim), which may be made by any person, including the undersigned, and filed against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city as apart of this application.
p
k�ip DATE p ` Z— Z o
SIGNATURE:
MIL' P1
PRINT NAME:
Bulletin # 100 — February 19, 2020 Page I of 2 k:\Handouts\Permit Application
VALUE OF MECHANICAL WORK
MECHANICAL PERMIT
Indicate how many of each type of flxture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe)
AIR CONDITIONER FIREPLACE INSERTS HOODS (commercial)
BOILERS FURNACES HOT WATER TANKS (Gas)
COMPRESSORS GAS LOG SETS REFRIGERATION SYST
DUCTING GAS PIPING WOODSTOVES
PLUMBING PERMIT
J$
VALUE OF PLUMBING WORK
Indicate how many of each ttjpe of fwture to be installed or relocated as part
of this project. Do not include existing fixtures to remain.
BATHTUBS (or Tub/Shower combo) LAVS (Hand Sinks)
DISHWASHERS RAINWATER SYSTEMS
DRAINS SHOWERS
DRINKING FOUNTAINS SINKS (Kitchen/utility)
HOSE BIBBS SUMPS
TOILETS WATER PIPING
URINALS OTHER (Describe)
VACUUM BREAKERS
WATER HEATERS (Electric)
WASHING MACHINES TOTAL FIXTURES
GENERAL INFORMATION
CRITICAL AREAS ON PROPERTY?
WATER PURVEYOR
SEWER PURVEYOR
VALUE OF EXIBTIN6IMPROVEMENTB
EXISTING/PREVIOUS USE
LOT SIZE (In Square Feet)
EXISTING FIRE
SPRINKLER SYSTEM?
Yes ❑ No
PROPOSED FIRE SUPPRESSION SYSTEM?
❑ Yes ❑ No
RESIDENTIAL - NEW OR ADDITION
AREA DESCRIPTION (in square feet)
EXISTING
PROPOSED
TOTAL
.................
FOR OFFICE USE
.............. ............................................................ ......... _........ _._..... ....... ---.............
FIRST FLOOR (or Mobile Home)
SECOND FLOOR
............ .............................................
_.................................. _..............................................................................__._
COVERED ENTRY
DECK
Q /
2g o
2-26
Z 2
GARAGE ❑ CARPORT ❑
OTHER (describe)
..................... _...._.__............----.__........__..___......................._...................----..................__....__...........
.
.
Area Totals
EXISTING
g C
PROPOSED
2�6
TOTAL
**NEW HOMES ONLY**
ESTIMATED SELLING PRICE $
# OF BEDROOMS
COMMERCIAL - NEW/ADDITION
AREA DESCRIPTION
Area in
S uare Feet
Occupancy Group(s)
Construction
Type
# of
Stories
Additional Information
NEW BUILDING
ADDITION
COMMERCIAL - REMODEL/TENANT
IMPROVEMENTS
AREA DESCRIPTION
TOTAL BUILDING
Area in
Square Feet
Occupancy Group(s)
Construction # of Additional Information
Type Stories
TENANT Ail I';A ONLY
PROJECT AREA ONLY
Bulletin # 100 —February 19, 2020 Page 2 of 2 k:\Handouts\Permit Application