98-100999 t`
o co
Ow w
I "I i'
ZNCJ\ a } co
w
CO "II A fli0m J
-J
41 / Pc 3
1
t� p O O O in
O O O �-
r`` O D N.O co La V
W W EA CC
g a
CCcc
a }
W Q
=
2
-I Lu
N W Q
.... CC
ce wW IL
U.
13
IL
O. CA
W LL .,
- Vl OC O
as
W (n u y Q _
z w 0 U
w CC CO -I U.
4 ~ w
•\,....1:
W Q
cc 0
Om N Q J 6 RI w a
rn w Q
M5 w
LSD gr ~ Q
W . z o
A o Q
CO to
V o
W w
w '� Z 3
al W p z
Cn Z ICI y U PI
` \ CO
N }
Z o 2 a v FWLL
cc 2
2 W Gy o x w O
0 Q
H \ w
O Q El a. a 2 1N H 'V Q W
.11 U o
O >4 Asa '' '° W O
W a.
Ca O w 1-3 o,n cii
AI W f'
�= z
W LL 14 li
I W 2 IAA H ` W
H O 1(1 W
pc
i4 0orfw sz , W CC
H V
CD � �
WZ
IA dQ
CC IA w
O. ai
14 M
W w •
. 11 N oi
• 3
P
H
H w
V.. D a c U. N
IA 10 to H O UJW C
M
U.
E I =CDW
CO H Z O
}
ch I a \
• r0 pepZ o
O CO 01 ei O o I
>OC'-OC' n C' 0cc
J � � NNE Om r°n n• Z
1A o• oo aCC CO w
Q AQ p ui w I- C'
W O N fn J>= cn
>-cn vn ~ CM
fn w
LWL ` 10 O � O 0 IL cC
$$x 3 c n S r W H Q Q
Cl Z 01-- sT OL Vl R' NW VlN = Ps
LL Il Q J U aOQ N J 2 J 2-W V/ H O O
CO itwO.ce •0 x000a= +�
O Q (a Q W W 3w►-O w . 2 N N G•-•a Q pE,
• LS) Cr) tr 0 OZNuw CO re 4t ce It N - tij- CC
w w I
Z
✓ M �iN cnaa I I I — o 0
BUILDING DIVISION
cfrr G 33530 First Way South
As .I--1 _ Federal Way,WA 98003
NW AY (253)661-4000
Fax(253)661-4129
APPLICATION FOR BUILDING PERMITr5
PLEASE PRINT APPLICATION # %��:7A
.'fig',`.•:: ':`ir':$::•::':'f::r'•,'w.wy}:';::tiir:'? :.':c3•:.•''.�::2ir`:r i;�:•i.:i`r��M1::>:;
. ;.,5`:: ,ww�:c Address
Tenant(if known) Lot# Assessor's Tax#
Buildin Owner's Name Address a
oMp'� Rom!/ �fl�7� B / y 142
a� e�
City l'C d *-P G%(�9� IState #i Zip 'gwAcr 3Phone .73^g37'-Seci6
Nature of Work %lte -t/a41.44s.A".7-/Z S'1"#*4
OffiiIY7can•::•::•;:•r:•`•:::•rr::c::':•`•:::?•:;•>:rrr••:...:i:•7::•:::.r:•r:
Name(F,M,L) ^/)DA,;le �e
!l.•PPvv
Address pi de l _ 6 iv
City � ' State Zip
ontact Perso Nn Day Phony'/ /j`jO`' Other Phone Fax
Company Name /4e , rez �, / /- e/7 ci!^ V
Address i // �7k JJ/Te '
City /i:E%/�/ �/L D� '/ ui ' - G State Zip 9 d o•r 2—
Contact Person , / s�Phone'LZ ?s7 Fax
C� T p
Contractor's#(card must be presented) Expiration Date Verified 0 Yes 0 No
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
1
[06.6WAREMEINIIIIIIII., isting P ose Use d Use
ro
i 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 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 Availabili 0 On-Site Septic System Availability 0 '-.Project Valuation $
Zoning I Lot Size Existing Bldg Valuation _$
?tj••::ti•••••:•:•.::':ii:}iiiJ:i::{:•.r.'iif ii:i i++Y::::i::':$::::j::yi'r'r i:::::::%:i':::�:::::K:::
#:Ckt �•ii'�.?:iY `:o•':::isiS:•:iS:`i'vfi::S'y;"+ti`'+•'ti::i<:4:i.
Name Address
City State I Zip
................................................................................
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes Cl No
N BINMCOMMOORNEMONE
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
KUM BING I IXT RE CO NM »pgg
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
...............................................................
.............. ...................... .....................
....................................... ....................
.............. ...................... .....................
....................... .............. ....................
Lavatories Washing Machine Drains Total FizLtire GturiY » >>>
MECHANICAVUNFCCOUNIUMEEM ANI AL MECHANICAL EVALUATION ONLY 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 10.4toiatca,iammomm
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 I•' E e m•' by any person,including the undersigned,and filed against the City of Federal Way,but only
where such claim arises o .f . reliance of the city,inclu.its offi , and employ,-.,upon the accuracy of the information supplied to the city as a part of this application.
d� 4&illL.dL / Date: r� �wer/Agent: ,�/
BUILDING.APP
REVISED 8/28/97