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-C� BUILDING DIVISION
an'or a Wn � i 33530 First Way South
Ef FU_lEIM
D 30 C r VEp Federal Way,WA 98003
(253)661-4000
NOV 0 7 1997 Fax(253)661-4129
Li I r LL-' rLL.:c1-IAL WAY
6UILDIN
APPLICATION FIk BUILDING PERMIT
PLEASE PRINT APPLICATION# BL•}-�4::7 7 pf it
z;1��'j .''. , ice.''%%/llj�:�l�� f%/l', �I
c,-$e . .:. sf` :'' F Address �jd 41 ' t-J 'Jj�3-'� •-��i.4 L- iv
Tenant(if known) Lot# Ass' 0��g x#^ 01/60
Building Owner's Name rgilAb 14)TDE" Address 4 '! 4 6 s . nL_T �
10DA, �7IIN1TDy S` �y
City Q4't- IJV 'State CA) - Zip le 7'� I Phor . 3 Er3C-Old?
Nature of Work
Name(F,M,L)
Address I" o s- (Jj"
City R�"L' yam' 1 State w/� Zip qtb '>'�
Contact Person �' Day Phone Other Phone Fax
Company Name C W A.fi
Address 15.74, s o I b IA— 1344
.l'6/v te*' /rd 66
City State Zip
Contact Person a 3�13
:. �-° :Fax
Pi --:. _ -:,;.,
Contractor's#(card must be presented) `BRucvurZ a 7 7"1+ Expiration Date Verified 0 Yes 0 No
�.;.`Y af F 1.'v}{:f••,`�,}• off•f��;f;�•)
Name f kiAi J 1 F— e
Address 1,a_i !Yl'r�, wk. 9Q / J p/
City `� State Tip
Contact Person P e Fax
LEGAL DESCRIPTION
•
Please Complete Reverse Side
•
.:, le- EMOSEREMERVERAMig Existing Use - <ON lent ` /L, !Proposed Use
-Permit includes: 0 Building 0 Plumbing ❑ Mechanical 0 Other
Type of Work: 0 Residential 0 New emodel 0 Number of Units— 0 Deck
0 Commercial 0 Addition Cl 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 Availability ❑ On-Site Septic System Availability ❑ Project Valuation 8 7/O—e'D '01_
Zoning I Lot Size Existing Bldg Valuation $
f it
Name 0¢t, Address
City tJ�/WIJ �V'v� State I Zip
Contractor Name Address
l 0-tcce 12elu ,t u44+ cc -r R-u.cm o A/.
City �—No al t='difi litt VIVA) r LC**cti b( State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
r;
Contractor Name Address
City State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
r".
Water Closets ••• Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heater' Sumps
........................................................................................................
Lavatories Washing Machine Drains Trtal:in irefiotiiwt >: >
•
ft. /r S„No, rr lf:'
• MECHANICAL EVALUATION ONLY $
Fuel Type(electric/other) Gas Dryer Air Handling < = 10,00t 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
Wood Stoves 3-15 Tons ;::,�. .., .
BBQ's Tat l►j�It�`Qiti >>` >>`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.
__..... l
Owner/Agent: - --✓ Date: 1/—7 y?
A
eutow.Mv
REveto er28ro7
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