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BUILDING DIVISION '
arrow G RECEIVED 33530 First Way South
� ____ IL Federal Way,WA 98003
uV Fly (253)661-4000
cH l.. 2 n 199e Fax(253)661-4129
1f Fry U,R,i l.'LriAL VVAY
A f N r:JQ i c,!. r pALDING DEPT.
I� I' = `_ �.= � . AP LICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION#lanCl . 595q
;°��.3{i::�:i c:..r:>»R�;`i`f:i5'% j` :;::: �::?:::{;:,::•;:i:>:::?;.;;act�:�:::i:::
x .w ::3, :i:•'• :^::: :;;:....� N>:•s:{ Address
[ €v { :>:::«:: :;>:::�:: :::x::: >::: A/SIPS 4M-61d y $WIN.
Twn) \ Lot# Assessor's Tax#
U.Jes-r
lieBding Owner's Address
Tl�J�1InY 1....rr , \1...1L.
City State Zip I Phone
Nature of Work VC�finG I 'El41---%, t►.14 rA /_L i t ? ri rlbu LA{_G_- K.r—t_O cA:re- "-wit)
•EL c- fl r#.JEL-S
.'•.'•:l ii::iii:ii�.'i�.'•j:�'i'niii:•:;t:;::;:iiii:i:}�ii'r4}t:�i:}S}:sji}ii:;i:;:;:�'riiii:::$iii ii:]L:iS:::i ..\ ;r,°.Yit.:::.v.::iiiiii:iii;?.'•�:¢;i:..:::. .......:.<: +:
n..Ftrat,4,91„,,,s c.,„,-. c_. t
AA, i fib E S,
�
city 4 l Ay State L 9 Zip Oi3
c,�n act Per Day Phone they hone Fax
�1o�ti i i s 838=G2� �uY,�7gs=9s'�G 8'3g'-O959
BUILDING CONM TOR<rr::> iiiiii
ammo«;
Co any Name
4. ate. Gt S 4t(tt-a..44'
Address
City State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
iAROMMEONMONIMiiIMENiMilin
Name p4(A
Address �T
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
- Please Complete Reverse Side
ISLIn Use
ed r0 OS�•(•:+:l:::��:. per'+
9 Use
Permit includes: $Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units— 0 Deck
0 Commercial 0 Addition 0 Garage 0 Shed 0 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 0 Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation $ It Oo
Zoning I Lot Size Existing Bldg Valuation $
•
fighingv.
• ::'.•::Y:ii.:8>:ry}�}ihv}:.ii.}x::::::::: v:.::v:;;•;;6:}:•}\l+:•>:G:4i:
Name A Address
City (�4 State I Tp
/
Contractor Name ki Address
City • ti State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes ❑ No
Contractor Name ki/A Address
A City //4 State Zip
Contact Phone Fax
" License# Expiration Date Verified 0 Yes 0 No
`[yE��E /
.XWiF'.�•R:i::{}•[:�yrydie:a[v�>=c?.C:i.:♦♦�:r:^•.:. �::ia}:�,:t.;'.i{�yiiy•?:::'::::+�>:::::::::.........}......
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Was'ers Drinking Fountains Other
Showers Electri ater Heaters Sumps
.............................................................
....................................................... ...
..............................................................
. ..................................................... ...
Lavatories Was ing Machine Drains Total.;FiatureCount; ; ; ;
MECHAICAMNi 'CCU til'!` >>>> » '::': MECHANICAL EVALUATION ONLY $
Fuel Type (electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons •
,Length of Gas Piping Range Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K 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 cOotit
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 owner 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 this application.
�r .,-gay .kc�
Owner/Agent:�-a C i4 Date: 7•21 !6
&nnrao.App
REvsEo 8/26/97
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