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10/06/97 NON 08:12 FAX 2066614129 CITY OF FEDERAL WAY fa 002
$ • MT.. a� BUUDINCDiv oN •
R E C E V E D 33530 First Way South IDEMPIL_ Fcdcrai Way,WA 98003
OCT 0 6 1997 Fax(206)661-4129c
LILY LDING DEPT. AY
APPLICATION FOR fi'UILDING PERMIT
PLEASE PRINT 13LTTji
�sy��- APPLICATION#
Address V.) Ta t" s 2
Tenant(if known) vivarr..4 Lot a '
IS'ggM zit:124
Building OwnersNeemo j 1 S It-ST -Ty‹.. Address � t
t �'�`�`�"` ►� i State Trp 'Phone r
Nature of Work Y ( l� �'ers rite(a ►�deors resra414
Name(F,M,L)
Address --�
City
State Zip
Contact Person 'Day
Phone Other Phone Fax
Company Name
{�2Cze�c..Y �V� C.s�NS-rfL,�c-`T'iO�J �,"[ram,
Address -wA _} �
City 13 e—1 <PA')WE< state Tip dA Ft1 Or7Q,
Contact Parson Fax
A--4 c'' Groc9PQ,c05—c�3r�R hone F
Contractor's I(card must be presented)1ZFL'1 �! .Q r � U S� Exp �Oat1 Verified 0 Yos 0 No
�1�. �
•
Name
Address
City State yp
Contact Person Phone Fax
LEGAL DESCRIPTION
PPl ase ame%te Reverse W
49/06/97 NON 08:12 FAX 2066614129 CITY OF FEDERAL WAY la 003
19
---!✓' d Use MIK
Permit includes: • Budding O Plumbing CI Mechanicet 0 Other
Type of Work: *basidential O New Remodeld Number of UnitsO Deck •Commercial 0 Addition O arege d Shed O Other
Enter 1st Root sq ft 2nd Floor sq ft 3rd Floor sq ft uE Existing Floor Area sq ft
Area Basement sq ft ys sq ft Garage sq ft Proposed Total Area sq ft
Water Availabili X Sewer•AvailabilitOn-Si S to Sys m Availability O Project Valuation S J I a d•Zoning j/�' !LLotSizo +T7 - Existing Bldg Valuation $ ?j '0
��^��'�' o:V'3� .'. .+(, s..w v.-SF,�.G:a z.�u�.:'iwn.• III
Name rt7 ( ['J /, v Address
Ci � !1/Y F�
State I ZI3
Contractor Name Address
City State 21p •
Contact Phone Fax
License P Expiration Date Verified CI Yes 0 No
..d
Contractor Name Address
State Zip
Contoot Phone Fax
'License P Expiration Data Verified 0 Yes 0 No
.rm5,i3;
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers plinking Fountains Other
Showers Electric Water Heaters Sumps
n w .:
Lavatories Washing Machine prams ""� »-�»J
"`L k�tkill:F.iiEri'i c�olfin'1 ? ��s
MECHANICAL EVALUATION ONLY $
Fuel Typo(electric/other) Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Raye Air Handling> = 10.000 CFM 30.50 Tons
Furn <100K BTUs Gas Log Unit Heater 504•Tons
Fum >100 BTUs Fans NAsceltonoous Fuel Talks
Gas Hwt Hood Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underound
880's i«�: f •. <. , ...
Wood Stoves 3.15 Teas
he above e•I premises
under pity ofperjury that the information furnished by me is true and comet to the best of my knowledge,and funhcr that Cam authorized by the owner of
! perform the Work for which permit application i.made.I funk:agree to save!armless the City of Fede al Way as to any claim(including coats.emenses,and
utorncye foes insured in invcatiga itm and defense of sedt claim). ' maybe made by any pe eson,including the undersigned.and filed against die City of Federal Way bat only
Awe such chin 'dace atlas city,We and employers upon the accuracy aftbo information supplied to the city as a pact of This application.
]caner/Agent: t-•C Dote
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