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BUILDING DIVISION
°1"'°" a 33530 First Way South
E F11-- Federal Way,WA 98003
C� t V E t� (253)661-4000
Fax(25316614 2
AUG 1 8 1999
APPLICATION FOR_,BLJILDING PERMIT e.—
BUILDING DEPT. befot O SI
PLEASE PRINT I Q . APPLICATION# <Li
:::::::<.::.:..........
•
:.;. . Siteaddressj2o`? — 2 ' S—32 /1 2z 3 2ZT
Tenant name �A1 Lot# Assessor's Tax#
�(Aa t ( w"k 1.1a oS
Building Owner Name 15.e.li �I,/__5a� Address
City +'K/�f I State . (/ Zip 'Phone
Description of Work 1,1,11 �✓I�vr�
Name(F,M,L)
Address
Ci State Zi.
Contact Person Day Phone Other Phone Fax
Federal Way Business License #
Company Name D.4,.../.1(4,1 pecx,444._ '�f' g—
Address cr2b 4— (45.Z7-
City 4( State t tn.4¢ Zip le66'
Contact Person (1 ✓ Phone , � 7- 2 B Fax
Contractor's#(card must be presented) ' Expiration Date 7!J Verified 0 Yes 0 No
•:•.;.:fir.+r .�
:•:.cx:'r'i.•';?:>.••.:::`:?> ::'.:....sk,..;{ss# '>�'+��f'�{'..:4,%:uyfyk,Yi,+`�k�,�':�•f:'�ff'E?.
:!!il�'•e.�.•K7:.�.k�:1Hf:.c,Sd�k.`. :" ' .:r. �i},':33i�`.•..���ti'4lGstsrwc
Name
Address
City State Zip
Contact Person • Phone Fax
LEGAL DESCRIPTION
•
Please Complete Reverse Side
•fi?if�?:':•:':';':ti{i:4'fii:t<:iii:yip>I }•4:;{;:ii:f'.
��(�. � ., ,< � xisting/ Use 1.roposed Use
Permit includes:+ ` ' ++ E3'Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: Q Residential 0 New ❑)model 0 #of bedrooms 12 eck
0 Commercial 0 Addition Ff Repair 0 Garage 0 Shed
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 Availabili 0 On-Site Septic System Availability 0 Project Valuation $ /5-/DOO.d'
Zoning I Lot Size Existing Bldg Valuation $
TO
.. :%t'f.f.Fi:3.••`ff,:,f%:•`•;%%%�i;%tS,':;::.ffF• ;i:4F;. r •r�y•>3:Y. ':.
'�:�:;{�%;f_r�; <:f.��;f:; •.. •: •f • For new residentie/on/y- Proposed selling cost: S _
meAddress
y State !Zip
hirwmiraliimvi
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
dpntractor Name Address
City State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
•y,>./f.•'•;ff.'t�'3:....i owifiami$.:uf oc�w_.;:F.:_f nvo�f:
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories WashingMachine Drains
T<1ta( =Fri>+Giui�t>'>>«>< <#>?>>>
. . , ;A UN W :-• MECHANICAL EVALUATION ONLY $
Fuel Type(gas/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
v 3-15 Tons Gti rtliti><.:>< > > > <
BBt2's Wood Stoves Fix'tal )tit
DISCLAIMER:I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and fiuther,that I am authorized by the owner of
the above premises to perform the w for whi • lication 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 inv def f 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 f e r of e ' 1 ' g its officers and employees,upon the accuracy of the information supplied to the city as a part ofq this application.
Owner/Agent: Date: 8 !Z `rt/
auaaw.Aa
REv6Eo 5/18/99
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