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21-102384- Building Permit Application -06-15-2021-V14 PERMIT APPLICATION CITY OFw../ PERMIT CENTER + 33325 8Lh Avenue South + Federal Way, WA 98003-6325 Federal Way 253-835-2607 + FAX 253-835-2609 + permitcenterialcityoffederalway.coin PERMIT NUMBER _ l� ` TARGET DATE E SITE ADDRESS SUITEIUNIT # 12. S . i Irk t PROJECT VAL ATION ASS ZONING ESSOR'S TAXIPARCEL # $ 60, 000. a� RS I D 3 _ �_ -0- z - o a --D- TYPE OF PERMIT BUILDING X PLUM13INIG IK MECHANICAL ❑ DEMOLITION ❑ ENGINEERING ❑rr�,FIRE PREVENTION NAME OF PROJECT I' � .� M }� 0 � c � - Wi u yr1 4 t ,8 DESCRIPTION �I R:eVPROJECT Detailed description of work to ' be included on this permit only NAME �� Ji6h/4,'4LJ PRi�{AiZY ONE PROPERTY OWNER MMUN ADDR M LJi � L h CITY 11TATI, VV ZIP a'Z3 RAME (' 46 i ct ,©Li f '(i C PHON , s E-SiAM CONTRACTOR �n 460 ® ' GITY � 8TATE ZIP FAX WA 8T TE CONTRACTOR'S LICENSE $ """A" ATE � � UnI N D4 z 6 NAME PRIMARY PHONE iJ Z MAILING ADD E-MAIL APPLICANT G i CITY 'h STATE, ZIP 3 FAM NAME F PRIMARY PHONE PROJECT CONTACT Z p2 MAMING ADDRESS ibiE- D , C c� 4 r (The individual to receive and respond to all correspondence CITY S ATE ZIP V! V F Concerning this application) PROJECT FINANCING NAME h h OWNER -FINANCED When value iS p^5,000 or more {RCW 19.27.095) MAILING AD REBS, CITY, STATE, ZIP PHONE 01 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 clahN 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. pp�� SIGNATURE: �j DATE tl PRINT NAME: -- Bulletin #100 -- February 19, 2020 Page 1 of 2 k:IHalldoutsTennit Application VALUE OFMECFfANICAL WORK MECHANICAL PERMIT s Indicate how many of each type o mare to be installed or relocated as part of this project. Do not include exLstiny rxtares to remain. AIR HANDLING UNITS FANS GAS PIPE OUTLETS OTHER (Describe) AIR CONDITIONER FIREPLACE INSERTS HOODS [Co —.11 BOILERS FURNACES HOT WATER TANKS (cas} COMPRESSORS GAS LOG SETS REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES VALUE OF PLUMBING WORK PLUMBING PERMIT $ v Indicate how man of each type offixture to be installed or relocated as gart of this project. Do not include ex. tiggfExtures to remain. BATHTUBS LAYS (Hand Sinks} TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) DRAINS SHOWERS VACUUM BREAKERS DRINKING FOUNTAINS SINKS (Kitchen/Utility) WATER HEATERS (Electric HOSE BIBBS SUMPS WASHING MACHINES TOTAL FIXTURES GENERAL INFORMATION CRITICAL AREAS ON PROPERTY? WATER PURVEYOR SEWER PURVEYOR VALUE OF &RISTIlYG Id[PROVEMENTS ]'qll T (41 "IftO l� j� !� III ` icy �� "(C $ 60' 000.c"o EXISTING/PREVIOUS USE LOT SIZE ]In Square Feet) EXISTING FIRE SPRI ER SYSTEM? PROFOSEn FIRE SUPPRESSIOF SYSTEM? �Q Qj#Ak'( oWn R �- �U t ❑ Yes No ❑ Yes ' No 1 RESIDENTIAL - NEW OR ADDITION AREA DESCRIPTION (in square feet) EXISTING PROPOSED TOTAL BASEMENT FIRST FLOOR (or Mobile Home) SECOND FLOOD COVERED ENTRY DECK GARAGE ❑ CARPORT ❑ OTHER (describe) Area Totals E=5Tmo movo ]f;U P TTAL **NEW 110AWS ONLY** ESTIMATED SELLING PRICE $ E # OF FOR OFFICE USE COMMERCIAL - NEW/ADDITION AREA DESCRIPTION Area is Square Feet Occupancy Group(s) Construction Type # of Stories Additional Information NEW BUILDING ADDITION COMMERCIAL - REMODEL/TENANT IMPROVEMENTS AREA DESCRIPTION Area to Square Feet Occupancy Group(&) Construction a # of Stories Additional Information TOTAL BUILDING TENANT AREA ONLY PROJECT AREA ONLY Bulletin #100 — February 19, 2020 Page 2 of 2 k.\HaudoutslPermit Application