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• •
SETBACKS & FOOTINGS
Date By
FOUNDATION WALLS
Date By
...............................
PLUMBING<GROUNDWORK
Date ti�6�jf By �i
UNDERFLOOR FRAMING
Date By
SHEAR WAIS
Date By
PLUMBING ROU/GH-IN Dat_ —e - 7 By Ø:î,)
GAS PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date By
INSULATION
Date By
GWB - 1ST LAYER
Date By
GWB - 2ND LAYER
Date By
SUSPENDED CEILING
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
FIRE FINAL
Date By
BUILDt FIN
Date / / By
OTHER
Date By
OTHER
Date By
C D0193
• •
City of Federal Way
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION #: gd'O4L}'3
SITE LOCATION Address
Tenant (if known) Lot# A sor's Tax #
e �i()L
Building Owner Name Address
City State Zip Phone
Nature of Work
APPLLCANT
Name (F,M,L)
AsommileortvtEE
Address ✓
;33 `3 Z 7 .S fl711-.s f•.-t r 7
City ,S
State IA.., (� Zip���ZC�' -/
Con Person Day Phone Other Phone Fax
h-r>? o6 $'i 7 2.0c
BUILDING COI4TRACTOR
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
ARCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
C00492 IRev 4 9J:.
Y
I •
STRUCTURE Existing Use Proposed Use
Permit includes: ❑ Building C_-Plumbing ❑ Mechanical ❑ Other
/ Type of Work: ❑ Residential ❑ New ❑ Remodel ❑ Number of Units ❑ Deck
p. Commercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability ❑ Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation $
Zoning Lot Size Existing Bldg Valuation S
LENDER
Name Address
City State Zip
MECHANICAL;CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUA IB ING:CONTRA CT O R
Contr for Name Address
k /lLtlLltStJ �� , ' X
2_7 -s 41f1 6,-A ,kr - eo
City ,'_';_,,,,,,J.,._
State j Zip
Contact Phone
Fax
R. cc_k � �;ci, �f�-t— ch -,
ZL
License # i)` G LK {9 Pc J I/ s.'C_ Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT .
Water Closets Sinks Urinals Lawn Sprinklers i
A. Bathtubs Dish Washers Drinking Fountains Other
Showers i Electric Water Heaters Sumps
Lavatories Washing Machine J Drains Total Fixture Count'
MECHANICAL UNIT COUNT
Fuel Type (electric/other) Gas Dryer Air Handling < = 10, 000 CFM 1 5-30 Tons
Length of Gas Piping Range Air Handling > -= 10,000 CFM 30-50 Tons
Furn <10OK BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans Miscellaneous Fuel Tanks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tons Total Unit Count
DISCLAIMER: I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge and further that I am authorized by the ovine
of the above premises to perform the work for which permit application is made.I further agree to save harmless the City of Federal Way as to any claim(including costs,expenses
and attorneys'fees incurred in investigation and defense of such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way
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 th s
application.ation. —
...
ownerlAgent: Qtii,/� 074. Date: Y __