93-100344 e
PI 91Pe
0 `w W
NA Qom
0O PI 3
p o0 0
NJ O D z
NOS M W
a1. Z N us
CC
ww w 5
2 0
cc W
W •* CC
a :y a
o W
aLL
N W[.) <
•-•<<. CC
Ci
W41\1)
CIL a vi LLa< WLLc)c� U. O1111.111 W .. < F}-
z w o Q
W U. I--
Q J2 W 00
CIG 0 a
y Q
W w
W ° I
3 Z O
Zw
LL 0
MIMI r •• la 0 V J
114 CO a a) 4• 0
0 � 0 a Y
0 W Z N }
o
V 1- W �
Q
Z w O
0
z =y� 0H I-I 4C cc)
OC HP V .1.. N 0 W
a Z <0 3 CVa a �` co ~
O I-<3 O_ wCZW O
D <w O O S H V
0 m I-= C Q No S 0 0 0 0 0 0 0 0 H W
I-W F- O nl� W _
CC
a zZ
W w 5 • as .•vi�� U �.
2 V 0a_= •zm0 M9-1 I d Q --•'/
�/�/�y� • �M10A =H>W rti
0�y • J W
WW • OM•-MtA W<O -141111
(.) 4.
kl m Za 0 w
CO 2
El 0 000000Ca 0100 C
•
a ' ' • '. • i i �- �►
COw02 co
Coo 000 1` .��
N x $N• . _dc Z ri T-o
CI 0 Z I<..2 00 W z< .„§
Q o .v1 O O x �4 CC
-I rn N "Ia 0 w 0 0 0
rl a
CC• CO (� 2N3 ao�000000 .� H F F- P
W <a I•? .. .. •. ►-a W I- w
W '• W fzr
t7 0
LL V j O .N 3 tel W 2 Y .: .Z. �1 = Q
p Ci z CO J IA a nr O •d' W Vl W I- O
LL LL 0 p J V vl< ra0I-M r c7 } O
p cew a IA I-•-••-mm a< o 4-) (/) LL t
O pip Q W LU wzO.w • avx cw� CC U
�,� o.. Tr V -) z oe a-0 o. z > c� fd Q'I F- W ai
›- y W0 4w1,-w M W V/a[ (naainzen ul Z E
•• M NCO F- < cr =mNli CO U..( U. 7UamO0CCC00 U �I
c� rILLco cnn. n. I - o
•
reiiinl rt
'Y OF FEDERAL WAY 3 '-
BUILDING PERMIT APPLICATION
- Please Print —
X 1 TENANT NAM
OWNER N ' f� SITE LOCAT �
OWNER'S ADD' S CI PHONE
DESCRIBE JO _
• THE PROPERTY IS OWNED BY: SINGLEIMARRIED /\ PARTNERSHIP CORPORATION
X 2 CONTRACTOR'S NAME Northwest Water T tAr CONTRACTOR'S REG. # NORTHWHIO 3R2
Card MUST t)e presented
CONTRACTOR'S ADDRESS 8201 rangn St _ SW • • CITY Tacoma PHONE 984-6404
EXPIRATION DATE 12-22-9
— OR —
I HAVE READ CHAPTER 18.27.010 RELATING►O DEFINITIONS OF GENERAL CONTRACTORS AND SPECIALTY CONTRACTORS AND
CHAPTER 18.27.110 WHICH PROHIBITS ISSUING PERMITS WITHOUT PROOF OF REGISTRATION.
X 3 CONTACT PERSON Angel Foster _ PHONE984-640.4
X 4 SEWER DISTRICT WATER DISTRICT •
X 5 ESTIMATED PROJECT COST .-AS EXISTING BUILDING VALUATION
X 6 PROPERTY TAX ACCOUNT NUMBER Ik CU- 01 t b
LEGAL DESCRIPTION
(If necessary, please submit a separate page with the legal description.) . . _ ..
K.C. Flat Recording # -
X 7 BUILDING SQUARE FOOTAGE:. (Existing/Proposed) 1ST" FLOOR / 2ND FLOOR - / •._ -
3RD - FLOOR / BASEMENT / • - - DECK I GARAGE • / -
X 8 ( ) SINGLE FAMILY ( ) NEW CONSTRUCTION
( ) MULTIFAMILY(NO. OF UNITS = ) ( ) EXISTING STRUCTURE • - __
( ) COMMERCIAL/INDUSTRIAL TOTAL AREA OF PROPERTY SO FT
•
X 9 PLUMBING FIXTURES rou
( 9 9 h-ins
) - - -
includin ME LAICAL APPLIANCES = BASIC FEE S_--- �-
NO. - -- WATERCLOSETS - GAS PIPING, FEET / ._ S..-_ .
BATHTUBS NO. b FURN E, ELEC. GAS V S
SHOWERS _ -" " GAS HOT WATER HEATER-- - - - .77 S----
.__.
LAVATORIES - - - . - - CONVERtON BURNER - -- -- - -.-- S-
SINKS BOILER, SIZE BTU $
DISHWASHERS • • - -_""-AIR HANDLING UNITS - S ----
ELECTRIC HOT WATER HEATER -.• .•. - . HEAT PUMPS, SIZE
LAUNDRY WASHER OUTLET _ UNIT HEATERS $
URINALS _ AIR COOLING UNITS, SIZE
. y
DRINKING FOUNTAINS •-- - COMMERCIAL HOOD . $
SUMPS, SPRINKLER VACUUM BREAKERS OTHER S
DRAINS . ._- ._
.
... .. . - OTHER _ S - - -
-- S••
TOTAL FIXTURES -
• TOTAL MECHANICAL FEE S
:RTIFY UNDER PENALTY OF PERJURY THAT THE INFORMATION FURNISHED BY ME IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
FURTHER THAT I AM AUTHORIZED BY THE OWNER OF THE ABOVE PREMISES TO PERFORM THE WORK FOR WHICH PERMIT APPLICATION IS
DE.I FURTHER AGREE TO SAVE HARMLESS THE CITY OF FEDERAL WAY AS TO ANY CLAIM(INCLUDING COSTS,EXPENSES,AND ATTORNEYS'
:S INCURRED IN INVESTIGATION AND DEFENSE OF SUCH CLAIM),WHICH MAY BE MADE BY ANY PERSON, INCLUDING THE UNDERSIGNED,
FILED AGAINST THr ITY OF FEDERAL WAY, BUT ONLY WHERE SUCH CLAIM ARISES OUT OF THE RELIANCE OF THE CITY,INCLUDING ITS
'ICERS AND E PL EES, UPON THE ACCURACY OF THE INFORMATION SUPPLIED T T 'E CITY AS A PART OF THIS APPLICATION.
•
NER/AGENT: DATE: I1 ?
i