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(253)661-4000 �` _ _. __. . Faz(Z53)�C�FiZ9 -- 0 i to -° APPLICATION FOR BUILDING PERMIT Gtisi ofpF Ise O 'A Q�� n/� PLEASE P/dWT" I2)"'I S'�113 APPLICATION# _L"�"t-I i j ,...." Site address ?0.234 11-1 n AVe ,� J E C tf A( tn.1/1 q/023 Tenant name /� Lot# Assessor's Tax# ( �flS r(. rre( i'Ml4D-0110'O7- Building Owner's Name Address Ctic15 C rr ( 34 3u Alit' 51, ) City I-a& A' wu.y State 1,0A Zip q 8o23 IPhone 2.,53-879- 82le Description of Work at p!Az envt7 o . 7213 Sc ECO 1 d 0L[. Name(F,M,L) i if' z7 rid-In-' Address QZ ; q 2 Lr 514.) 'd City r e tlCX'a) V1LAy State 1N`/• Zip 96023 Contact Person one OtherP one Fax ��,r,S C rtl Day P � ry ' Z 253-46/-, V 753- g7z/-g57, le tr:xim fo<el %: y .: Federal Way Business License # Company Name Ai I a k Address City State Zip Contact Person Phone Fax Contractor's #(nerd must be presented) Expiration Date Verified 0 Yes 0 No sii f f4. :1�.:�{v.fR•..Snr.T.4.rK .'f^ { Name r I Address At r� City State Zip Contact Person Phone Fax LEGAL DESCRIPTION 1 i 2 ` lock 2 , V .I� (,�J C i�'1` AdQ r T.'w. 4.t.v Please Complete Reverse Side '0 1/ &b.4\r‘ .}•f✓::..:'4"• rN••i::J/ rif:i -riff':;Lxv.:• r' aft. sting Use .pro osed Use c J.:`'::..f.�..'...'� � ••�.�> mom..•: �C1 Gk.. P CC k Permit includes: B"Building 0 Plumbing 0 Mechanical 0 Other Type of Work: residential 0 New liemodel 0 #of bedrooms 0 Deck 0 Commercial 0 Addition 0 Repair ❑ 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 32 sq ft Garage sq ft Proposed Total Area , sq ft Water Availability 12" Sewer Availability 19-- On-Site Septic System Availability 19-f Project Valuation $ " ' ow Zoning I Lot Size , Cl A L Existing Bldg Valuation $ I 08, 0O 0 ^f• For new residential only- Proposed selling cost: $ Name Address City State I zip Contractor Name Address City State Zip Contact Phone Fax License# Expiration Date Verified 0 Yes 0 No Contractor Name Address II City State Zip I 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 Heaters Sumps Drains' Machine >::::�:» :«t+Ei' tlk�'�':' < < •>>'.><'Lavatories Washing '1�tr:Cs�..�xitt • I ' a:. 1 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 BBQ's Wood Stoves 3-15 Tons >��tel'(Jf�C.. . 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 officers and employees,upon the accuracy of the information supplied to the city as a part of this application. Owner/Agent: Date: . REv O 5119199 rI rr••,�,-� t. .��+� — ......- - ----.....—.-- - - --...a—..aa ill a u $ o O a s a a a �.. 4 il = Ct 4 '/' 6 '+ 1 N..- - q r•{V's,. I . g 4 . — 4 J Ltd. I 9 x 4 1 a a j .• 53 3 N �• $ • how II } .. 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