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BUILDING DIVL4[ON
CRTer . 33530 First Way South
EI=F1L Federal Way,WA 98003
FiMe (253)661-4000
Flat(253)661-4129
APPLICATION FOR Baii_DTNig PERMIT
GI• I r.,. tnL. aVAY
PLEASE PRINT , BUILDING DER#PUCATION# j L q q l -0 EH
% .,;.s;,$ :: i' s min _��'f% Address 2 7'3 14 24-11' Q 500TT1
Tenant(if known) .� { Lot# Assessor's Tax#
CON - ,4M mot VA/ M�ifv�{ GO•
Building Owner's Name 0 Address
CON •A''1 ARIA WAOrel'rt'Or C
City L W.A'f 'State Zip I I aF-6
Nature of Work P'I>PL. 01,604erefieter OPrice's/ lEWA-rio'} cF roes 5-r I zi
Name(F,M,L) i ' y woors A
Address 27 3 )el2 4 -1.� F V Se�
City PePE/,/ro i.. VIA'`j State Zip
Contact Person Day Phone Other Phone Fax
vZ trtIGI< So 13 2c 3- S3`L .668E •
: ' :r f:' 'f FEDERAL WAY BUSINESS LICENSE #
Company Name arL t C� � G�O
Address 7/1 s• W sT
City State WA Zip G1 l ) 31
Contact Person Cc,p „) T'lye IJ✓_S Phone Fax
Contractor's#(card must be presented) '"` 1'" Expiration Date Verified 0 Yes 0 No
D7• D1 �I "I
a°' • "ice''. ...... ligagess
Name Ptiptl g NfJV 1
Address 1,to 7 NI EMI -. 5D#V •
City 6- 1 , E. State Tip
Contact Person C f)124 SiVrPrell r I Phone Fax
LEGAL DESCRIPTION
-.- - Please Complete Reverse Side
YN ,,.A.Existing Use AFKIrhAelUT GLUBPbu— Proposed Use 64 Y1L
Permit includes: Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New Orliemodel 0 Number of Units_ 0 Deck
I /Commercial 0 Addition 0 Garage 0 Shed 0 Other
)(Enter 1st Floor 2 r 1 1 Z 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 Availability0 On-Site Septic System Availability 0 Project Valuation $ 4�I
000•-411. is
Zoning I Lot Size Existing Bldg Valuation $
+rr,. q'� r
Name Address
City State I Zip
Contractor Name Address •
City State Zip
Contact Phone Fax
License if Expiration.Date Verified 0 Yes 0 No
'F.ontractor Name Address
city State Zip
Contact Phone Fax
License i Expiration Date Verified 0 Yes 0 No
•
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers ,Drinking Fountains Other;
Showers Electric Water Heaters Sumps
...................................................... ......
................................ ......... ........ .
Lavatories Washing Machine Drains `TiialFixtiueouriE ;,,......:..
ari.....:.'.: : •i �•��"�.'�: �';n''.'.r. N' MECHANICAL EVALUATION ONLY $
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
BBO's Wood Stoves 3-15 Tons ]Total:kli(t `outtt ''.> • .> •;;:..-
DISCLAIMER:I certify under penalty of perjury that the information furnished by me is hue 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 o employees,upon the accuracy of the information supplied to the city as a pad of this application.
Owner/Agent: '/�� rer Date: O3 2
4P '7 7
Ilmow6.Are
Remo 6/28/97