95-102198 r� M 1A N
V" O PgI Cr 1 in
w w
o
- a co
aO eh co
w
1A o oo10 F-
O D m M va re) cu
M cu
Lu
- cc
www to j
g a
w
w CC
0 >.
I- � 3
w
U.uJ
� Q
0. 2 CC
OC ¢ W
WO -I CI
11 Y o-. a N W
u.
2.M J w Y.
mim oe zLu
0
2 ix
L.
to N coY. cC 1
Z cu
W I-
O Cr)
CC W-J U. t- • w
LVW CO
M � etn
i
M H a
n in
w
Wcr) I-
3 Z o
z ii
oa
z .
PA 0
U) a ww
a z0 -1
o
� � 0 0Y
(I52
)I-Z a FAw z Q o
0
Oto c H } w
Q w a El Q m
� a y= 0 o =
1.-- o yo g w
V o DC W S
= _ M
o Zz '- 0
CCI-
W� fpuWE QN¢ m
H d W
Emu z...--� •.O~ W CC
U CA..t F¢- P CCl ,1
O
2 o
W Z
d Q
lit w
Om Q �
cs• W N
W w
Et •
la
a Yco
COwil piicc
_ 0
U W
Pi 7 aL =
c O 0 v.
4 a WS 1- Z
� w ww cc
EI M O x O ul Z
co 0 p, 0 `11
enN 1 a 4111,
O co 01 I-1 O Ni s M�n.�e. C'.n• O
Jed) NN co 0'fel M • Z
Q >`Q O („;0. co w cc W C~ w
cc as LL 3 .. J IN
>3 Y C.1 n ~ ~ \
_ Z
N • W -la).- N >E ,- w
111 N 05 cc O 0 LU <
323 tail f Cs I) = Q
LL `. p 0 Z H a0~OJ N CC CA I OC o
LL L.L O Q J 0 ¢ N J 2 J 2.. W Vl } 0
LI p W awo•w .o xo¢0aa LL ar
Q W Q W wr-ow ZN NC .+C C� E
nes L. V n ZZ'D� W 2 U.W I..- L La
LS) -0 , LU CC O O f N LL tail - I-0- W Z 1
VMU. CD V) a. a. 1 0 O
SET BACKS AND FOOTINGS OaT0 POUR FOUNDATION WALLS PLUMBING GROUNDWORK
DATE__ BY _-__ DATE _ _--_gY __ ____ DATE BY
PLUMBING ROUGH |w vVATERL|wE0x. � MECHANICAL INSPECTION
DATE_ _... _ GAS PIPING OX.__.... _- _ DATE _8Y
Oa, T0 ENCLOSE FRAMING INSULATION WALL BOARD AND FIRE WALL
DATE_____�___-oY _________ DATE DATE BY
FINAL 0.K. TOOCCUPY
oCo pao Fo {_,��
DATE
_ _ sY_
'
_
_
'
City of Federal Way RECEIVED
v`� ���L APPLICATION FOR BUILDING PERMIT AUG 3 0 1995
,vl f�D UNDER 1994 UaC CITYOF FEDERAL WAY
B
BUILDING DEPT.
PLEASE PRINT APPLICATION#: t—
SIT. . .OC .TION f > R:ii < ':z _<'.
�:.��.T4�T��N.......:..:.;:r;.......:.....::._...:. :.: Address
Tenant(if known). Lot# Assessor's Tax#
�I.J ELL c52104 -`3031 o
Building Owner Name Address
PC:owt---D 1 2Dt00D'--
City PEb • Y" State Zip 3 Phone e z -is 2_22 1
.T/
Nature of Work /7 �r' D F. k/e
APPLICANT
Name(F,M,L)
fri i`i N 1`
Address
1 )0L 2 54 I4-1 City ✓A( — State t�Q Zip ' C 7't -� /i
Contact Person Day Phone Other Phone Fax
BUILDIlVG CONTRACTOR
.....................
Company Name
Address
City
State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
ARC�IITECT
Name
Address
City
State Zip
Contact Person Phone Fax
EGAL DESCRIPTION —'
Please Complete Reverse Side
CD0492(Rev 4/93)
S'RUC TURE Ex. Use P sed Use
Permit includes: ❑ ouilding ❑ Plumbing 0 Mechanical ❑ Other
Type of Work: X Residential New ❑ Remodel 0 Number of Units 0 Deck
0 Commercial 0 Addition 0 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 0 On-Site Septic System Availability ❑ Project Valuation $ j )` SC'-,6 -
Zoning Lot Size Existing Bldg Valuation $
..................................... . ....... ..
LENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date 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 FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT COUNT
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 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 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 laim 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.
Owner/Agent: Q , ��-.1 Date: -`�,J �J
/