95-10149707/05/95 0?:33 BUFFALO DESIGN
RECEIVEE) City of Federal Way
Aph�:ATION FOR BUILDING PERMIT
JUL 0
,I,ry OF, N , _.F, F- G OFALT�AY
PLEASE PRINT ButtP APPLICATION
I
Company Name
Address
City
Contact Person
�k
Contractor's # (card must be presented)
002
State Zip
Phone Fax
Expiration Date Verified 0 Yes 0 No
07/05/95
07:34
BUFFALO DESIGN 003
STRUCTURE
Existing Use
Proposed Use
"L3th'Qer
Permit'includes;
Building
❑ Plumbing
❑ Mechanical
Type of Work: ❑
Residential
O New
Remodel
❑ Number of Units ❑
Deck
Commercial
® Addition
Garage
❑ Shed ❑
Other
Enter 1 st Floor
sq It
2nd Floor
sq ft 3rd Floor
sq It Existing Floor Area
sq ft
Area Basement
sq ft
D40
sq It Garage _
sq It Proposed Total Area
sq ft
Water Availability
Sewer Availability On -Site Septic System Availability
❑ Project Valuation S
/15/71
Zoning
Lot Size
Existing Bldg Valuation $
LENDER ..
Name
Address
City
State Zip
MC C AL + OD RAC'
Contractor Name
Address
City
State Zip
Contact
Phony Fax
License N
Expiration Date Verified
D Yes GI No
Contractor Name
Address
City
State zip
Contact
Phone Fax
License r9
Expiration Date Verified
O Yes 0 No
Water Closets
Sinks Urinals
Lawn Sprinklers
Bathtubs
Dish Washers Drinking Fountains
Other
Showers
Electric Water Heaters sumps
Lavatories
Washing Machine Drains
Totahixtute Dount'`
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 <10®K BTUs
Gas Log Unit Heater
50+ Tons
Furn > 100 BTUs
Fans Miscellaneous
Fuel Tanks
Gas Hwt
Hood Boilers
Above Ground
Conv Burner
Duct Work 0-3 Tons
Underground
BBo'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 Investl stion 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 suc Itt�'aris5v as t f 1 a allanoa
of ity, including its officers and employees, upon the accuracy of the information
supplied to the City as s pan of this
application.
QwnerlAgent:
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