97-102870«reor G
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PLEASE PRINT
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EujiLDINGDIVMON
33530 First Way South
Federal Way, WA 98003
(206) 6614000
Fax (206) 661-4129c
APPLICATION FOR BUILDING PERMIT Cl-I _ I0a-9"Ta
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APPLICATIM & `R1.-. I I 0 4 T I
Address � O j ,�Gr ri � C � So 4
Tenant (if known)�s n�� ` /Jj
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Lot # I�
Assessor's Tax # �9
Building Owner's Name
Address SQL
Ci t v
State
Z �D 7J
Phone
Nature of Work 5�4—e�41.
Name (F,M,L) D4 [✓!.W� Sb .n� �'�tf' (sue �L[ �7` iClZ�s hC % -
Address / �) �j v
Ci
State ��%
Zi % a a�
CCon t Person
Day Phone / / / �b
Other Phone,)/�
Fax
Company Name dC �� �-�`kj TI ' L(G �� (� C
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Address
7 77G
Cit 0/)-, AL
State
Zi 12-1
Contact Person E
Phone �- 3—�ba�
s'y3-sly
Contrac ar's # (card must 6e resent d%, / /
c !� Ga C TO 55-6 �f Y� LlC P/h Ic )
Expiration Dat
p Al�
Verified ❑ Y ❑,No
liJ%„L.
Name
Address
Ci
State �%�
Zip�D
Contact Person Y� /G /
Phone, � yg
Fad `)
LEGAL DESCRIPTION
Please Cgmnlete Reverse S►de
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Permit includes:
Existing Use
❑ Building
❑ Plumbing
Proposed Use
❑ Mechanical
Other
Type of Work:
❑ Residential
❑ Commercial
❑ New
❑ Addition
❑ Remodel
are e
❑ Number of Units _
❑ Shed
❑ Deck
Other
Enter 1 at Floor
Area Basement
sq ft
sq ft
2nd Floor
Decks
sq ft 3rd Floor sq ft
sq ft Garage —sq ft
Existing Floor Area
Proposed Total Area
sq ft
sq ft
Water Availability
❑ Sewer Availability
❑ On -Site Se tic System Availability ❑
Project Valuation
$ 8s --00
Zoning
0
Lot Size
PA
Existing Bldg Valuation
$
Name JAddress
Cit V State I Zin
Contractor Name Address
City State Zip
Contact Phone Fax
License
Expiration Date I Verified ❑Yes ❑ No
Contractor Name lu
Address
Cqy
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Water Closets Sinks Urinals Lawn
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains 7rrAi:
....(
Fuel Type (elect ric/otha0
MECHANICAL EVALUATION ONLY $
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
Conv Burner
Duct Work
0-3 Tons
Underground
BBQ's
Wood Stoves
3-15 Tons
Iota; E.TITIi lrAl{31L --:-;-
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
attomeys' 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 ofthe reliance ofthe city, including its officers and employees, upon the accuracy of the information supplied to the city as a part ofthis application.
F J r
Owner/Agent: Date:
c.
Rc sm 12/11/96
97-!a0 9"7a
CITY 4F FEDERAL WRY PERMIT NO: BLD97-0471
33530 F i rst Way South Jrl,141l, ,,,Ill .E. E.....11!;"� .7N. ilr�,pi ��t`,',',+!' iN °�h' if!�';: iIN ��1! INS �I' .,,N!,: Ifs... ISSUED: 08 / 1:8 / 9 7
Federal Way, WA 98003 Building Inspection Requests 253--6u:l._.41_ 0 BY: FC2
253-661.-4000 EXPIRES: 02/14/98
ADDRESS:36605 PACIFIC HWY S
NO.: 292104--9074
PROJECT DESCRIPTION :HYLEBOS CREEK WEST FORK STREAM REHABILITATION, PROJECT INCLUDES STREAM REHABILITATION, PLACEMENT OF ROCK WEIRS AND ROCK CASCADES, SLOPE STABILIIATIO1
OWNER �� �--= -= ____—_=--=---==_�-=_=_�==�=�=i= CONTRACTOR -_-_-_--_-.- ____ �_______ _�_____4___ - LENDER
- CITY OF FEDERAL WAY PUBLIC WKS i w�-
j 33530 1ST WAY S
FEDERAL WAY WA 98003
661-4074
*** CONTRACTORS, PLEASE USE LOCATION CODE 1732 WHEN REPORTING SALES TAX FOR PROJECTS WITHIN THE CITY OF FEDERAL WAY. TAX RATE = 8.2t ***
1 BLD?:X MEC?:? PLM?:? FLR--EXIST--PROP--- DWELLING UNITS: 0 COMP PLAN ......... :LDSF FEES:
TYPE OF WORK:ALT USE:PUB 1ST,: 0: O:sf STORIES........: 0 REQUIRED PARKING..: 0 SPRINKLERS?......:? # PLAN CHECK FEE
CENSUS CATEGORY ..... :999 2ND.: 0: O:sf HEIGHT.....: 0.00 ft HAZARD CLASS...:?
OCCUPANCY GROUP---------- 3RD.: 0: O:Sf VALUATION---------- REQUIRED SETBACKS-------- FIRE FLOW....: 0 gpm
:? :? :. OTHR: 0: O:Sf EXIST..$: 0 FRONT.......... 0.00 ft
TYPE OF CONSTRUCTION----- BSMT: 0: O:sf PROP ... $: 0 SIDE..........: 0.00 ft WATER SERVICE..:?
:? :? :? :? DECK: 0: O:sf REAR........... 0.00:ft SEWER SERVICE..:? t
OCCUPANT LOAD ------------ GAR.: 0: O:sf RECEIVED.:06/01/97
i 0: 0: 0: 0: TOIL: 0: O:Sf IMPERV SURFACE: 0 sf SENSITIVE AREAS?.:?
FUEL TYPES.:? ? FANS..........: 0 BOILERS/COMPRESSORS RATER CLOSETS..,.,.: 0 URINALS........: 0 TOTAL FEES
GAS PIPING.: 0 ft HOOD..........: 0 0-3 TON.....: 0 BATH TUBS..........: 0 DRINKING FOUNT.: 0
FURN<100K..: 0 DUCT WORK...... 0 3-15 TON..... 0 SHOWERS ............. 0 SUMPS........... 0
GAS HWT.... : 0 WOOD STOVES...: 0 15-30 TON...: 0 LAVATORIES.........: 0 VAC BREAKERS...: 0
CONY BURNER: 0 FURN>l0OK.....: 0 30-50 TON...: 0 SINKS ..............: O DRAINS.........: 0
BBQ........ : 0 MISC..........: 0 50t TON.....: 0 DISH WASHERS.......: 0 LAWN SPRINKLERS: 0
GAS DRYER..: 0 AIR HANDLING UNITS FUEL TANKS--------- ELEC M HEATERS...: 0 OTHER FIXTURES.: 0 �
RANGE......: 0 <:10,000 CFM: 0 ABOVE GROUND: 0 LAUN WSHR OUTLTS...: O
GAS LOGS...: 0 > 10,000 CFM: 0 UNDERGROUND.: 0
PERMITS EXPIRE 180 DAYS AFTER ISSUANCE IF NO WORK IS STARTED. RESIDENTIAL AND GRADING PERMITS EXPIRE ONE YEAR AFTER DATE OF ISSUANCE.
I CERTIFY THAT THE INFORMATION FU SHED BY ME IS TRUE AND CORRECT TO THE BEST OF NY KNONLEDGE AND THE APPL CABLE CITY OF FEDERAL WAY REQUIREMENTS HILL BE MET.
OWNER OR AGENT, DATE
_..._-______.._._...__------
$ 0.00
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