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City of Federal Way f
APPLICATION FOR BUILDING' PERMIT
PLEASE PRINT APPLICATION It: 13 /0q5 06/31
SITE LOCATION Address 29800 24th Pl . So.
Tennt (if known) Lot# Assessor's Tax #
Royce M. Price
Building Owner Name Royce M. Price Address 29800 24th P1.50
CityFedgra1 Way State Ala ZIP 98002 Phone 8 3 9—ZZ 17
Nature of Work replace existing gas furnace
APPLICANT
Name (F,M,L)
City Sheet Metal
Address
4202 Auburn Way No.
City E ii$X Auburn State Wa. Zip
Contact Person Day Phone Other Phone Fax
Patti Cunningham 852-2174
C'TTYSM* 1 7"1,TA
M DINGCONTRACTOR
.......................
Company Name
Address
City State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified ❑ Yes ❑ No I'
•
...... ...... ..... . .. ......
ARc.f.M.O.taggenEgitiMMEN:
Name
Address
City State Zip
Contact Person Phone Fax
1
LEGAL DESCRIPTION
•
Please Complete Reverse Side
CU0492(Rev 4/931
•
$4I'RUCTURE ;fisting Use Proposed Use
Permit includes: 0 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 ❑ 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 $
Zoning Lot Size Existing Bldg Valuation $ ..
LENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City shPPt MPfia1 4202 Auburn Way 13o -1—
City State Zi
Auj.�uiii Wa. pA8nr»
Contact Phone Fax
Patti Cunningham 852-2174
License # CTTYcM* i 71,TA Expiration Date
i—i—9 Verified 0 Yes 0 No
PLUMBING CONTRACTOR;
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUMBING TIXTURE COUNT`
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Frith t.e Count.....;..__ . ,....?
MECHANICAL UNIT;COUNT
Fuel Type (electric/other) gas 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 j 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 lam 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 at-tome ees Inc ed In investigation end defense such claim),which may be made by any person,including the undersigned,and filed against the City of Federal Way,
but only here such clai arises of the reliance of t City,including its officers and employees,upon the accuracy of the information supplied to the City as a part of this
applicatio
e -
Owner/Agen. /A (Jr53
��V��� `� Date: