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an'or City of Federal Way
�
EJZFI
L- RECFR/Rp
_ __ APPLICATION FOR BUILDING PERMIT
JUL. 2 1998
PLEASE PRINT Cl l Y v Ciil vL AY
APPLICATION #: 0.ill:301NgG�pT
I S r :.:UCATION J Address 1 ' �J
Tenant(if known) •
Lot #
Oi i����� Assessor's Tax #Building Owner Name 1 Como
l Address
()Nov le,t Col i s on 346a1 - I(0 Ave.
City �P�� cti State S.
WA- Zip Ci 3 I Phone (361)) (L 9-3,6�)
Ong...Nature of Work n ' loA- (lilylIJi1a
APPL4CAN T , <I
I :<
Name(F,M,L)
L_ S�JAS 1in e.._.
Address
• 300 S VYyCUry iiV Cad . NEB
City
Oki mp to i.State A- Zip c 8'S, (�
Co to t Perso l �/,�_ Day Phone C�
N\Lb\t Me-AitMo earn)-75 ! -3 � Other Phone
??''� 4!/ jj �Y�
�7�D�)`t'Slo"tr7
BUILDING CONTRACTOR` I
Company Name
r- 5 c .
Address
ZOOS . Vkd1arVkn 1d . NE
City CI VIA -
Contact Persb State Zip G�g Si 6
Phone Fax
ICI i c o\e_ i Alkiste4 _ 0)45/ 3aoa ( 'o) '5 --o tos--
Contractor's #(card must ba presented) Expiration Date
_V U E S 5 p Verified ❑ Yes 0 No
LccT
• Name
Address
City
State Zip
Contact Person •
Phone Fax
LEGAL DESCRIPTION
C ak` _1,-!,ai0,tih 4\c\. - P0,0(i:.0 .3
'IAl fl 9_a S4r (.,- 1 c OP LLYV f, kC--X- A(ICO G•`Ct)c d1�"1 q
q 0--01( 4- (L0C.. itsCc-,i * CA \ :km, C - J
pat- "-).) r•Ak en1/4.,uvtl , WO-S\loil-k-ciri
Please Complete Reverse Side
C00492(Rev 4/931
ExistingUse Proposed Use
STRUCTURE • . p
Permit includes: •Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential )(New ❑ Remodel O Number of
I .XLCOLT msrr•iil O Addition e - D Shed i 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 sq ft Garage sq ft Proposed Total Area sq ft
Water Availability 0 Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation C. 'I(0-0 0
Zoning (' ote\exc eLL I Lot Size G►S( x 34b 1 Existing Bldg Valuation $
TENDER
Name Address
City State I Zip
.......................................................... ...............................
...................................................... ...................................
MECY ANICAi, CO iTRA:CTOR
...........................................................................................
...........................................................................................
Contractor Name Address
City State ' Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
•
•
Pb.101B01 CONTR ACTOR
Contractor Name Address
City State Zip
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
............................................................................................
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total ixtutkgooErtz»>::::m>: : :
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 Boners Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's Wood Stoves -1 3 5 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 arise • t of the reliance of th its officers and employees,upon the accuracy of the information supplied to the City as a part of this
application.
Owner/Agent: i-' 7
.y
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