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W V CC Y Cal CJ II = ¢ o <C CD C) <C <L <C if CC W uJ !"'F CO GJ i� '� tl if CO F-- V O •- •- O it u_ C9 C. [.7 V C CD C C•, Il CC V 2 BUILDING DIVISION arroF G 33530 First Way South '\ EMEMFill— r. ^-`IVED Federal Way,WA 98003 (253)661-4000 Fax(253)661-4129 WAY APPLICATION FORti@DO PERMIT PLEASE PRINT .. ,. APPLICATION # tL T -0 'O ItiltgairaignintilialniAddressS01034 v- y WA `-%UJ3 Tenant(if known) Lot# LOT 5, RL�ock.�t Assessor's Tax# • IV Ve.nro V. I�0 0.1a- ecz 14-TS,VoL6I VbL(nt. K C- Ocl 1800`Oa(o5-03 Building Owner's Name Address SAµe 5a'I^e- City Sp-M` State Zip So—m-e— Phone A53-5aq- 1-1c33 Nature of Work onve 4- ©r'e_ ('a( Goro&j . +o IIr o T ocrY jAPIMANDiiiiiieminblainngsgai Name (F,M,L) we e ry S• 'N�a ��� Address •2 e A.6(--4 C City 'P c�aL W�� J State (,�c x— ZiP q &0C)3 Contact Person P�F `\ Day Phone (% 1_133.3 h 9_'1 Faxo J ,1-al l Company Name S1ar�E FYS PPP Address City State Zip Contact Person Phone Fax Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No Name SPWO E A-s P ke-Ar\-1- Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION 3Lcx J r r, �c�T `J , ;?I�� IJ k_Cc cdec I r\ Vo\ume \ (r)c- 91c�.-}� c- e (o\ in ' \r Please Complete Reverse Side f` :0::::::,::::::::ii:iii*]:::]:::i:::i:mimiiiiiiiiiiiiiiii:]iiiiiiimiii]i:i§:ii::iiignommimiggii V / ..}....... ExistingUseProposed Use L..�. 11'\ bC> G� r-�� G. R m P t;�R�y��p� FZ I Permit includes: 1$. Building 0 Plumbing 0 Mechanical Other Qd • Type of Work: CIC Residential 0 New 0 Remodel 0 Number of Units_ 0 Deck 0 Commercial 0 Addition 0 Garage 0 Shed 0 Other Enter 1st Floor f sq ftI 984 2nd Floor pia sq ft 3rd Floor f/Pr sq ft Existing Floor Area geSk4 sq ft Area Basement (l//a- sq ft Decks sq ft Garage 33(„ sq ft Proposed Total Area /3aa sq ft Water Availability 14,I Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation $ 5;t`,Q()� Zoning R 1 6-CTI-1-1 c2L_ I Lot Size 9 I oPCD SO rT Existing Bldg Valuation $ ..4lii:?i{:11�:ii} :;: iiYyi.;Ci. ti}}ram}1i>:;}::4l Name Address City State I Zip #w,.i�.....<.:�:..•:x.�:.y.�.'..{..w..:...:;.:::.,ot�:::�y::i�isi::i:::i::i::i::'.:�>yi::=:: :ti::ii:;:; ?:;:': 1Kt ..K ANI�'-A C.O. Rf1C'�.Of7-i #<f : s Contractor Name Address City I State Zip Contact Phone Fax License # • Expiration Date Verified 0 Yes 0 No Contractor Name Address n 1 A City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes 0 No ....................................................:: ::::................................ IUJ BtNG Ft 'CO N' `' <>z% '< Water Closets Sinks .Urinals Lawn Sprinklers A Bathtubs Dish Washers Drinking Fountains W Other Showers Electric Water Heaters Sumps o a......ctvre>C ur E> > '' <' '> Lavatories Washing Machine � Drains � __ ................. ..__. ....�........... ... .:v::::.................................................................................... ONLYhatilANMAIMNitttagerEEMER AL EVALUATION $ MECHANICAL C 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 tot............_G....................................... 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 reliancep of th ' ,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application i 4\7 r Owner/Agent: Date: C S •O(, wa.Arr -\ • \,. Ea 8/28/97 _. . •• 4-. 0-.0.- ; -0. .-, _ • . 4 41 4 . ri ... SI CD 3 ., C.:A a cz a .4 CD CP .on NC i 0 `.r.... 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