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21-102993-Building Permit Application-7-21-21-V1py� jj PERMIT APPLICATION PERMT CENTER + 33325 81h Avenue South + Federal Way, WA 98003-6325 �1u (91 253-835-2607 ¢ FAX 253-835-2609 + peruuteentex@cityoffederalway.com PERMIT NUMBER - TARGET DATE SITE ADDRESS 7 6 1 J� 5 Z-S 9 SUITS/UNIT 8 jj Cam- 0� vLvAy -Pd o-r r ri � 2- I) y-7 PROJECT VALUATION ZONING ASSSSSOR'S TAX/PXRCEL II TYPE OF PERMIT © BU DING ©PLUMBING ❑ MECHANICAL ❑ DEMOLi' ON ❑ ENGINEERING ❑ FIRE PREVENTION NAME OF PROJECT PROJECT DESCRIPTION Detailed description of work to �� be included on this permit only NAME PRIffiARY PHONE Me- Ji �� PROPERTY OWNER MAIL GAD REss, t S . CI sTATE z>P 4, NAME w— PHONE r �i WAILING AID DRESS V-0 E-MA L e TA 14 CONTRACTOR CI_rI STATE ZIP BAA r WA STATE C ONTRACTOR'S LICENSE ! r EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE 0 NAME PRndARY PHONE a�.;O�i INa AM DRESS ox K-0 u , APPLICANT CITY STATE zIP FAX SAME PRUdARY PHONE PROJECT CONTACT ,1 I � IN DREW (The individual to receive and respond to all correspondence concerning this application) CITY STATE ZIP FAX PROJECT FINANCING M ❑ OWNER FINANCED When value is $5,000 or more (RC W I9 27.095) MAILING AX DRESS, CITY, STATE, ZIP PRONE I certify under penalty of perjury that I i = the property owner or authorized agent of the property owner. I eerft that to the best of my knowledge, the information submitte in support of this permit application is true and correct, I certify that I will comply with all applicable City of F'ederaI Way regulatt ns 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 Wag 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 oft reliance of the city, including its offleers and employees, upon the accuracy of the information supplied to the city as apart qj this application. SIGNATURE DATE '� l PRINT NAME: k S� 1/ Bulletin #100 — January 29, 2016 Page 1 of 2 k:IHandouts\Permit Application MECHANICAL PERMIT VALUE OF MECHANICAL WORK Indicate how many o each type o e to be installed or relocated as art o this 'ect. Do not include Sxdslin fixtures to ® AIR HANDLING UNITS FANS GAS PIPE OUTLETS remain. OTHER (Describe) AIR CONDITIONER I FIREPLACE INSERTS HOODS (c =udg BOILERS - -- FURNACES - HOT WATER TANKS.(Gay.. -- COMPRESSORS GAS LOG SETS _- REFRIGERATION SYST DUCTING GAS PIPING WOODSTOVES PLUMBING PERMIT VALUE OFPLUAIRING WORK Indicate how MEny of each type of Aictui e to be installed or relocated as part of this m'ect. Do not include existing res to remain, to BATHTUBS (of Axbj a c.�rol LAVS ISeoe aid) TOILETS WATER PIPING DISHWASHERS RAINWATER SYSTEMS URINALS OTHER (Describe) _ DRAINS SHOWERS VACUUM BREAKERS e DRINKING FOUNTAINS SINKS Iwmhm/awry{ WATER HEATERS (el,wsq _ HOSE BIBBS SUMPS WASHING MACHINES TOTAL FWURES y-� GENERAL INFoRmAmN CRITICAL AREAS OR PROPERTY? WATER POR YOR SEWER PURVEYOR VALUE OF EXISTING 01PROVE■ENTS EXISTING/PREVIOUS USE LOT SIZE (2n q¢ara Feet) EXISTING FIRE SPRUou 6YBTEId? PROPOSED FIRE SUPPRESSION SYSTEM? ❑ Yes ❑ No ❑ Yes ❑ No AREA DESCRIPTION (in square feet) FIRST FLOOR (or Mobile Honte) COVERED ENTRY ' A —. Bulletin , s mm 9100 —January 29, 2016 Page 2 of 2 k:V-Iandouts�Pemut Application