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.y j ����✓ BUILDINGDIVISION
a1c, G. 33530 First Way South
(206)661-4000
t Li• 1AL WAY Fax(206)661-4129c
CttGi
BUILDING DEPT.
APPLICATION FOR BUILDING PERMIT
PLEASE PR/NT APPLICATION# R`"0 7 02 O
,: ,f;; :$:<r Address 3 alt,z 7 lip Qvt''. S _
Tenant(if k . n)PLE TLC aL i , O pj Alpttiptcn Lot# / ff, Assegsor's Tax�F �'�70 Cti7Yo
�1 / 17zO
Building Owner's Name I Address
W1 tI Iawl V\L Mt@.1 tI I 3/44,2_7 !6 • Ave SC) .
City 11EC4g tt%a�J (State (AA Zip Rio0 ,A I Phone ZOe,_ 837.. 44 33
Nature of Work c2/l)S+& Dow ci it2t -I- Sr- ati 60$,tn .&J -. kau Se eX.-/t/fo; irve/,an Lc4
(%r'^ •
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f i'f},r:l�%f ....
Name(F,M,L) plitek
wM..
14;
Address 1-eze 3'`6�7
F v
City .D al (,IJ p'/ State I/V a Zip 0 OO '3
Contact�jerson Da Phone Other Phone Fax
( PAL& i",+0luPscr.4 �- 'l`l 1 - 04 Z6 Zoe .`77to-1917
Company Name t ik t /� •�
Y V mac) L.¢7ov.7. m l-t IN % 1 1 t ttv.
Address Po,ecC coos City L1 LI 14 W O C1 ek State UV-A ZIP 41130443-S'o0 3
Contact Person
Phone Fax
-4evlr.l Ir34Cr w� lit- 09 -1 16-1117
Contractor's#(card must be presented) Expiratipn Date Verified 0 Yes 0 No
4-Yv£Sotro -7? 0-7_ f nD 9$l�/
7 ;::::75.(l.f lYl h,1
Name
Address
City State Tap
Contact Person Phone Fax
LEGAL DESCRIPTION . t m G t A.D y)
VLor l7 l e EL_Y 124+
CITY D t PE( („ W
Please Complete Reverse Side
.. ., , ,,k .. Existing Use B o rho P I Proposed Use 6 c p
Permit includes: ]k Building 0 Plumbing O Mechanical 0 Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units 0 Deck
Commercial 0 Addition 0 Garage Shed [-}p kr21 _(p�L Other Spray 12,t+,
Enter 1st Floor %boo sq ft 2nd Floor 14 /4. sq ft 3rd Floor sq ft Existing Floor Alta"�j is sq ft
Area Basement Na sq ft Decks sq ft Garage A((A sq ft Proposed Total Area <./1 O sq ft
Water Availability' `0'Sewer Availability On-Site Septic System Availability ❑ Project Valuation $ 414)10 d()
Zoning R. , I Lot Size ' - ray F-}-, Existing Bldg Valuation 8 Z6-/ 4o •
; 353/ 0 ,
Name 8),
, ,• N Address t
(-(,� 33310 PQLI t /G u1-LjiCo
City FE.b AL W A V State W A J rip f3063
raw.
�� ...
Contractor Name Address
City State bp
Contact Phone Fax
License# Expiration Date Verified 0 Yes 0 No
.
.,... ...... :• .ter.•
Contractor Name Address
City State Zp
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 f.;;} ; ,�.:....;, �..,,f' ,,
Washing Machina Drains :OtAIVIAW*Wft' '4 -..,„ ' .
' � � �t'f".G 3� {!fltor/+.tli ,,,, '/
• • - - } / MECHANICAL EVALUATION ONLY $ /5—vv
Fuel Type(electric/other) ( Gas Dryer Air Handli a < - 10,000 CFM 15-30 Tons
Length of Gas Piping Range Air Handling > - 10,000 CF� 30-50 Tons
Furn <100K BTUs Gas Log Unit Heater 50+ Tons
Furn >100 BTUs I (Pie OF Fans 1' (,Ppga of, Miscellaneous 1
1 "` Fuel Tanks
Gas Hwt T304-741 Hood Boilers Above Ground
Cony Burner Duct Work 110&kW a& Otl 0-3 Tons Under.around
BBQ's Wood Stoves 3-15 Tons •.)'tjt �?43j :> ';iii.'fxS:,'.,,�?:✓,'.' -, ;
DISCLAIMER:I certify under penalty of perjury that the information furnished by me is true and correct to the beat 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 empl upon the accuracy of the information supplied to the city as a part of this application.
it � G
r/Agent: Date: /9 7
sueaw.n/.
Revels 12/11/00
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$� i 1 ��� BUILDING SECTION
APPROVED
AS CORFe g�
d,�i
BJECT TO FIELD'INSPEETTIION. z g
t! 1 a x 11 i i• ,�DIRISIGHT OR VIOLKIONS OF CITY E2p.
L. o E ANCES ARE N� INCLUDED IN
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