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Ce •• h►~- s s U cat/ eri o: W 42 0 W O. a = DC A CO 'J �" o ttlUm A • OJ � lWitNUW. N 150. W V � aMZV � QS � NQH I.r W ►-+ CO QSRI AOQ'0- m � vo •• Us .. o •• 1+ COau m adea umLLc� ¢ zaM !. 0 R 44 0 City 0 ,a ��G�`,�� C ty of Federal Way - ##! €KNIT - —_ a t ��NG OEPT PLEASE PRINT AY APPLICATION #: b o- O Z Z SITE LOCATION Addres c49g c') bl3 3.. rd a.Go • ; v30,4,v, k J, A CI g 0 a 3 Tenant(if known) Lot# Assessor's Tax# \\elope-- r1M c YAL. C�.a e o1a'o. -Ciel3 Building Owner Name Address 1 elAV\efiA aand Yy, ( : �a,tne City airAe I State Zip �/ r I PhoneQ5 3__ea z•_ QC.�,tL Nature of Work ce 1�Cp ,p pika nno,ny AJ'� F (A)1 ')tu en bi 1'f'n. 0 _ T APPLICANT Name (F,M,L) Address City State Zip • Contact Person Day Phone Other Phone , Fax Ci-6Me Y' .Q5 3- S'?z ,- o/411 BuumNG coNT CTOR Company Name' 1 _ t-t0t15+cT\ E Mtxr 1_se 5 , Address • 11931- 50• 3caL* PI •City u en State kZ . Zip q 1 %0 a3 _ Contact Person Phone Fax Tfxcr1 \Oust r V35•btocl-1 Contractor's #(ca must be presented) Expiration Date Verified 0 Yes 0 No OrkfL k'e - 13_1 1 k1-5-`11c, ARCHITECT Name A i Pr Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION AP„Sc ri +tt,h a t e - 4e; .e_ .sicy -aft pro ves\ Please Complete Reverse Side C00492(Rev 4/931 STRuc E • fisting Use \(n (Q roposed Use Nse Permit includes: K Building �'' Plumbing Mechanical 0 Other I _ Type of Work: ,i Residential 0 New 0 Remodel 0 Number of Units ` rikDeck 0 Commercial 0 Addition 0 Garage 0 Shed 0 Other Enter 1st Floor VI/(P sq ft 2nd Floor laq(o sq ft 3rd Floor sq ft Existing Floor Area sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area a(et, sq ft Water Availability Sewer Availability 0 On-Site Septic System Availability k Project Valuation S Zoning I Lot Size r t3 X g 0 Existing Bldg Valuation $ 4760- 12 —15. 0 23. 20 ........................................................................................................................................................ .............................. ....... ........ .. ............ ............. ............ ................. LENDER Name Address 1� 1VAM Ut�1J�0.� • City �r-OA IZipQg�� State 3 . C ON RACTOR Contractor Name Address • City State Zip Contact Phone Fax ` License# Expiration Date Verified 0 Yes 0 No ........................................................................................... PLUMBING CONTRa4CTOR V\ I A Contractor Name Address City State Zip • Contact Phone Fax License# Expiration Date Verified 0 Yes 0 No PLUM'BIN(FIXTURE COUNT n I A Water Closets - J Sinkstki-scbita Urinals Lawn Sprinklers Bathtubs a .. Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories 4 4 Washing Machine j. Drains T6 j< j jjg twpkjjj '2. MECHANICALVNIT COUNT. Fuel Type (electric/other)9ctS Gas Dryer Air Handling < = 10,000 CFM 15-30 Tons Length of Gas Piping Range I Air Handling > = 10,000 CFM 30-50 Tons Furn <100K BTUs t Gas Log Unit Heater 50+ Tons Furn >100 BTUs Fans if Miscellaneous Fuel Tanks Gas Hwt 1Hood {,1_ Boilers Above Ground Cony Burner Duct Work 0-3 Tons Underground BBQ's Wood Stoves 1 3-15 Tons 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. X �'Owner/Agent: Date: 5 .{_- 1 Q '» , 4 .1,41 � �q �31 - 23KI � � R AlRj adti 1117 ata I S /An) ma Je) 1 L& L2 LT & 0,'6, Of f A g?tatrtur rr&im J, riff Weal- 0 8 jc-Y 2& 78 EXP. R£S SRC• ,`i 1 EXadAthtal.b Foa Tgt fou„DA-I'co,U, A&1tD 140 SOT i 1 t Q pc+r ..1-1J ,Y4ti- 0 F 711C VII_Ae OAS DOTE) MAtili , A lUEL) &JAW £A5/ , c.d.ic,l .ncc` ,Tr. asivtgooke/ �oe /�if MOT 3 UNS (Tad' ri031i�.0'7160 -rota ou V1 fY 1144t 1I . H0ME KE G -6/16E 5.3 - E33 8-04(14/ 1:eitlw ,i4eripc--%---- si. . fio 1(v.,,e k 2 i'.° , I 1§(;4, �,,,� t CEIV�D i> VfAi�\ ,, JAN21999 2 0 I`v 7 e .) , CITY OFLDING FE W* BUI 0 ...a-a*......... -.-. • 74 . e"0 , • . , - 3.... 3. ,... _ - ,-.4- --• _ , • -a4- .u.. e4.4 . AY* .1104 =3. 4.1. :.•• = --- - 4 -• - r .... IL • fa • a , 1 ... • lei • a • C.0, ee 4 4 a IOW 4 MC • •"4, • 4....., •.4. . ' 44. ' vai a- FR •Z = filA • en \i:: - ..-. .3 .,-; wo.1 Cs: aw - • 0 a• eae 43 1% \.tat 0, 3= 0., 'I.- = CD e-t3 4.3 , ••••• .-- > , .0 I .... 43.. , ',Oa Ci.. 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