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LL. r-I O UI N !— W N : DC OL l- O J N Ca • • W I•.•/C W 0 MO U) C�IV `� e» oo Q > ....0 Wiac • iic a_ v 1 0 !.- 't W W do cp" U) per.� xosna •• c .• . � �_ � �~ �5 y o_ �r a ce •• 1'7 i W OW 0 : AG 'NiaCOdi .411 i=/l i � D - a 11)V A • O � N .-ILA Co > Wyaa .n •� oQ QO �QQQ W CO (D \O CI ~ VO •• 1— .. O •• LL GO IA. OVAacvacg � RECEIVED Ce City of Federal Way JUN 05 1995 1=PY APPLICATION FOR BUILDING PERMIT ATV OF FEDERAL WAY �.� ( O 1 BUILDING DEPT. PLEASE PRINT APPLICATION #: BLD q 6-`D*24- SITE LOCATION Address /oo/ 5.6,4/7/, 32 7rA, S, e67" Tenant(if known) Lot# 7 Assessor's Tax # 3 2-6o7o -0730-O6, Building Owner Name Address 5r'EPA'1..//F 6orterr /DO/ 50. 3Z 7nV 57 City�FaEiPAL lt/�f/ State Zip 9B a 0 3 Phone B 3 9. a Nature of Work ,ivEe 1m4zzocvH vD G-4PA,t/I/DJ eDp/,7.4_4/To ex/' /3 5PD27' ,e,AoL•tice APPLICANT Name(F,M,L) S�.yE .etAI.e c//7. 1 Address City State Zip Contact Person Day Phone Other Phone Fax BUILDING CONTRACTOR' Company Name PO CQ.c/ST,P&G770Ai Address 22 6 /3 re✓ Srx r67- 'E. City ,c/R(/.fA/ State od Zip )QOO Z. Contact Person Phone Fax dice x/Ec.s4..14/ 13 9-58 go Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No Do-AL -LC-2J1A1 ARCHITECT Name CO.(.40 D 4/, M BRA, iA:"C////ret Address 830O /2 t Q 16w,5E City A/a'c.4STze State (,,,/A Zip yiOfri Contact Person Phone Fax Cof/ /c1/GE2.4 Z26-//81 LEGAL DESCRIPTION Za, 75 /✓E._/r1(E a/Ew ; Afccoe.o/.r>/J ro T.,!iE "'GO rierKegiale,PEco tn® /.c/ 9/ Ore- 1DL.17`'S/ /�•S 7/ /Z , Please Complete Reverse Side CD0492(Rev 4/93 :UCTURE Existing Use Proposed Use ,QEs/�E r/�E iP&vsi1J.A.t/cE Permit includes: / lM Building Plumbing /Mechanical 0 Other Type of Work: Residential 0 New @emodel 0 Number of Units_ 0 Deck 0 Commercial II/Addition 0 Garage 0 Shed 0 Other Enter 1st Floor ,t/G sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area /, 3 97 sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area `.biti6 sq ft/76 / Water Availability liEK ewer Availability • On-Site Septic System Availability 0 Project Valuation S / 9' 0op. Zoning f 7. Z "- [Lot Size a/ Ira te . Existing Bldg Valuation 44. T7e.%1 LENDER ``(' Name /L/f Address City State I Zip . MECHANICAL CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License it Expiration Date Verified 0 Yes 0 No \_ PLUMBING CONTRACTORi .� Contractor Name - Address City Staff Zip Contact Phone Fax License // -' Expiration Date Verified 0 Yes 0 No PLUMBING FIXTURE COUNT Water Closets Sinks ' Urinals Lawn Sprinklers Bathtubs I 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 1 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 i 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 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: ` f' ��/[.,/ � EiljC/�,8e//teeer Date: 5",% (W./1".c' _ ,...„ _�..... ..... ........... _..-_ 41 vj-- -- I --: �'- C _ '1 4..4.hid+.M in. rqs (p D T�""y� y 8 R h Re 4 MI I . 4. 4.. 4*1. 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