06-102423CITY OF k �...�✓ �2— — —t t '
Federal Wad
PERMIT SF MF CO ME EL PL DE E FP
COALMUNIFYDEVELOFA(ENTSERVICES AAY 1 5 X�PLICATION
33325 8rx AVENUE SODU1- FO BOX 9718� FEDERAL WAY. WA 98063-97f8 T°
253.835-2507• PAX 253?35.2M OF FED EI�At,
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A
BUILDING DEPT.
The followirt is re celled i rmation -art InCom lets a llcation will not be accei2ted. Please qrint leglb!q in or type.
M PROPERTY
'} INFORMATION
SITE ADDRESS y [ ; ' �` S '� �J •� '� c- 46410 ( SUITE/UNIT # ( v
ASSESSOR'S TAX/PARCEL # - LOT SIZE (s )
LEGAL DESCRIPTION (e.g. Acme Estates, Lot 1)
(Attach separate page for lengthy legal description)
■ PROJECT INFORMATION
TYPE OF PERMIT ❑ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING KFIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
PROJECT NAME (Name of Business or Owner Last Name) „ ca L �C' +
PEOPLE O• •
PROPERTY
OWNER
CONTRACTOR
APPLICANT
CONTACT
LENDER
EXISTING USE
NAME PRIMARY PHONE
C_A 3 E-= ALA c (--e ( )
MAILING ADDRESS CITY, STATE, ZIP
�s — s 316 ilz�t sr—ck4Nva
COMPANY NAME
o&-r,�=crA
APPLICANT NAME
M kcL Qc-, aka
OFFICE PHONE
(206, ) 72.?
MAILING ADDRESS
CITY, STATE, ZIP
63
CELL PHONE
(23
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER EXPIRATION DATE
FAX NUMBER
— — — — — B L
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with etch application)
o t5�6F0�r1'ZPr
EXPIRATION DATE
02/�� iz
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
( ) Y
RELATIONSHIP TO PROJECT
❑ Architect ❑ Tenant ❑ Agent
ther (Describe) W �t���� Q.� O
FAX NUMBER
( ) -
NAME
V 7-
PRIMARY PHONE
E-MAIL ADDRESS 1
MAILING ADDRESS
NAME
CITY, STATE, ZIP
PHONE
( )
EXISTING ASSESSED/APPRAISED VALUE $
PROPOSED USE
VALUE OF PROPOSED WORK $ / SDv•'0-
SPRINKLERED BUILDING? U YES ❑ NO FIRE SUPPRESSION SYSTEM PROPOSED%REQUIRED?RYES ❑ NO
WATER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ❑ LAKEHAVEN ❑ HIGHLINE 0 PRIVATE (SEPTIC)