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BUILDING DIVISION
r' G 33530 First Way South
Ea __ Federal Way,WA 98003
GEevEp
Fax(206)661-4129c
it Q `p0
of FEoeRA .l'IIPLICATION FOR BUILDING PERMIT
clrY
null o1NG of .8741StL P4 N ' `�?- °°1 fr 4
_EASE PRINT APPLICATION# lIlI 00 W5
: }ocA a :,` .:�:h::: : :f: 1 234 2 S. Zec) ?/1 PL64c<. _
q< rt?�:; ''.��'�% ��'.'��' Address
RiQViltii:ARi!�7F..r:�f:.;fi.:r%f::,f+,?'./'f.'S:•}F.f.:.u'.?•i>`Jf.}tf.
Tenant(if known) Lot # 32 Assessor's Tax #
32.E -OA() 032 G
Building Owner's Name Address
SG N rl E=1 C7i=R M S I IJ G . !'D 5 I b -O Li T 1-lC t...KA I!_g- B u/ D.
City1ZI ILI4J IL /d (State k-J A Tip 9 )I '3 e3 Phone 2.4125-2,lF 7 I
Nature of Work CO I�(S'f' IGT N 1=1",..) -E►j I p 1= J G a....•
Name (F,M,L) Sc-4-I N (7e-R T t0f E-- IN - .
Address co5 10 Vie,u TI4 6 .--IJ- - 51--V c
City Ill 4 J ILA State le-1 A Zip g ? I b'
i Contact Person Day Phone Other Phone Fax t
MARK- 6Au DI I.I I 240 247 I •2-42 -42fI-3 .
.........................
ii&
Company Name, 5 N E-117 14 o 1-1 E_-✓ I Q •
Address i!C 1 b el
-N H T C.i-- V L p �p _
City 1 u i,..k L ,J I . State L JA FC-�
Zip "DQ,I �
Contact Person , •A-IG 6P+u D I tJ I E.R— 2 Phone Fax
-2 4-7 I Fe2 41"2_ - 412043
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
5cHN EI4--2.45P�) a/1/pgi_ _-
:., fti'�y,:.,f.:;.¢•r•:;ti.c.>i�:;:;::;%f•^;;,`:,�::%�? .3�ifj.
!Name rri6.16, N . 1 -os
Address
2'7 5c, R 9 AV ... 1--1 ._.city ...As..T I L_-I State I•-J A zipc�p •J E) I G
contact Person Phone Fax
C. P A IU (?.-e'SS 3 L-9708 34;..a I--97c'O
-L DESCRIPTION to 7 32 NE R!TA 6 W co j)it/
r
r -
P/e acra CO17701t?te R.'verst, Side ,
I•%vo. XG'!.$)`:3::••'f:•r •r:%`�'�,,:%::::�•:::t..r;�}•.i%`it,G.':t�5:v::rpri•,••x'::
.5 7 mall } "$':fit''if Existing Use
Y• .
�.,t_ !Proposed Use S3IVGLG FagM7L.Y
Permit includes: . uildin
!a'r+ g 0 Plumbing 0 Mechanical
Type of Work: esidential ❑ Other
New ❑ Remodel 0 Number of Units 0 Deck
0 Commercial ❑ Addition ❑ Garage 0 Shed
Enter 1st Floor/249 sq ft 0 Other
2nd Floor //2 0 sq ft 3rd Floor
Area Basement sq ft Decks sq ft Existing Floor Area
sq ft Garage 5�rj sq ft Proposed Total Area seller-sq ft
Water Availability Sewer Availabilit sq ft
��On-Site Septic System Availability 0 Project Valuation $ 2,Z.O 000
ZoningLot Size 83 75 S••F'
Existing Bldg Valuation $
. .. . . AK, :— a :v
c
Name
Address
City
State I Zp
•
Contractor Name
Address
City
Contact State Zip
Phone Fax
License#
Expiration Date Verified 0 Yes 0 No
bap
Contractor Name
Address
City
Contact State Zip
Phone Fax
License#
Expiration Date Verified 0 Yes 0 No
kilitily., .
Water Closets 0 Sinks 2
2-
/ Urinals Lawn Sprinklers
f.
BathtubsDish Washers
Drinking Fountains Other
ShowersElectric Water Heaters
Sumps .:...,:;:;:•:. ::::,:;::z:•::>:_,:; <:.;•.... _ .
Lavatories Washing Machine .••••>� �:...:.:•: ....
Drains . ... ...:{::<;��s>:>:�:<i� :::
.Total<iCii'i f:V toUiit' i
IECOAMPAttUNI 'COU " "'"' `k'``'$ MECHANICAL EVALUATION ONLY $ 3 50
Fuel Type(electric/ the 1/. 6AS Gas Dryer
Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping � C ,tC', Range
/ Air Handling > 10,000 CFM 30-SO Tons
Furn <100K BTUs 63ae: , Gas Log Unit Heater 50+ Tons
Furn >100 BTUs Fans /G
`� Miscellaneous Fuel Tanks
Gas H / Hood /
Boilers Above Ground
Cony Burner Duct Work
0-3 Tons
BBQ's Underground
Wood Stoves 3-15 Tons :<:>:,:...; ..:;:::>::::::...:::...:..........:.....
Teton Unit'Caunf"it >'.<�?i
CLAIMER: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
hove 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
:ieys'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
such claim arise 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
or/Agont: t%% ,62 ".7 , '//SL ��Ad�%_i L 7
,.. Date: I
'II1/MI
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A8 V19-9--- al ea
NI-HDfOtH DNIeINflld
7- Ae 5))k1 o%-1 oleo
S11VM HV3HS,
�i7 A8 ,g- --/ alea
i
DNIWV Id HOO13413aNfl
A8 oleo
)11IOMONf10t39 DNIBVYfl1d
A8..162
9)1--5-� oleo
S11VM NOI1VONf10d
^( - ales
J iQ A8 -j k'
J �1
SDNIIOOI 'I; S)IOV813S J