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Bun.D1NGDIVISION,
anof 33530 First Way South
ED8J Federal Way,WA 98003
FM' (253)661-400G
1V �— - — ._.
Fax(253)661-4129
--ECE
•
MAR 0 5 19APPLICATION FOR BUILDING PERMIT
G1 fY ui-Ihti)tAAL WAY .L"1� 1�� `�
PLEASE PRINT BUILDING DEPT. < 2 4 ^L APPLICATION#
%�`':: .w f��` f`l{f�ff:J�r,+f,�� fnr.//i�`'iS::{,/•J n G
i E�� �,'t�s�� # .��r�,�i����,� ��i/;%.':fi'%'!�%'''•'//a:G Address 1��n J W
Tenant(if known) C t A sessor's Tax#
r% Lo #
S Olosre\ - v►ca0Cli C Aci4 3 -nlfo- o
Building Owner's Name Address
I C�lr�S 3U�31 2.`t 1' AN/4-
City Fed ell W cA. State 1 1 Zip q18 02 3 I Phone 263-66/-2 5 Nature of Work (IEP1 rep0(u1U ate
fly.» '%% l 4 l/f i1..,1J
Name(F,M,L)
�r� s Alin etif
Address 3 g 3 d
L! n 4 Ave S�
City Fe de 011 in) y � State w A Tap bv2-3
Contact Person 1 Day Phone 253- 661 Other 9-63 nVe1q-8,2 D Fax"16]_B7'/-g jqy
aegisr• o-.`r a .;s
:
. .. ... .
Company Name s c - r
Address
City State Zip
Contact Person Phone Fax
Contractor's#(card must be presented) Expiration Date Verified 0 Yes 0 No
Name Se (r
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
UN\ ft-044.coil .a dcck rv.y Ivt)Se ,�,�d.&ft 5tu rs ?> Ncw c/FLk
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Please Complete Reverse Side
?fc,.• e • o ! :.,,,:,,.:, , ,,., Proposed Use
�;: i �/o : : ":; / /..::U�l,/,/i ElpSting Use P OQLIiG
Permit includes: 0 Building 0 Plumbin. 0 Mechanical 0 Other
Type of Work: lir Residential 0 New IEVRemodel 0 Number of Units_ 6'beck
0 Commercial 0 Addition 0 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 -i,2, sq ft Garage sq ft Proposed Total Area sq ft
Water Availability S, wer Availability0 On-Site Se tic Syst m Availability Project Valuation 8 I(o,43
Zoning 0S'•Aer'+'—1 f1 1/4 ,"q (0I Lot Size 1 Existing Bldg Valuation $ -gy-f-,��+,''
1 �UU l/
Name Address
City State 1 ZP
,,,v ,tr,•.. , l :. ::""'Jl.:./�/lJ <l/s,milJ yf
Contractor Name Address
it(A
City • State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
Contractor Name Address
ra IN
City State Zip
Contact Phone Fax
License S • Expiration Date Verified 0 Yes 0 No
.r' ,
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains • Other
Showers Electric Water Heaters Sumps
.............................................................
.................... .....................................
................. .......................................
.................... ......................................
... ....................... .............................
Lavatories Washing Machine Drains Tr tel:F i(tu'e o E g � » < >
} : 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
L.
- 5 Tons ....
BBQ's Wood Stoves 3 1 'I'a1:el)Jrtiti�4�ttittt: ': �`'>>>> >><><;
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 asi 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 empl ees,upon the accuracy of the information supplied to the city as a part of this application.
Owner/Agent: a:VI Ct " C Date: 7 " 23 9-6
ae sb8/25Ia7
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