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96-102959v D m m �t� cn �aU) xvaxtAak- m T Z m v v N N Z z0a0n vim zrzr < mmamm cn cn m Mm J 3• Vl mA •J 3 � y om V1 m . � . J mm •J •J •J • •J • < 0 0 m 0 x �= 0 mmv z v o v T C o •1 X •J N H N MroM `J 0 H H °x 0 0 C T 0 --I T Cl)N vv T cn O m v z N 3 r 1 m cn T cm a• z• m• tO64 OD N U N O N 0 00 0 00 >a N T N CD C) 00 •o ro T N W o n N r S n o � m M N x A r W rM Cc000 < x m N c (n 000 a 0 r O W 03 r -A N _0 C) aoao t-)o1z 0 4.. A 1 aao� C A —1 aw�pu •O = z .11 N < rm;o 0 C-) m � n .� . z 11 Zpn z v CD ti0m �i0z> I CD W� 0 0 0 O`OO m - m :. M �N� v DD A o v w cn N N 000 00 0 0< 1+D Z p 0 I O S> H N W W, to w :00r x r m H H mn x m y0y '..wJ VJ ro H H 0 pq tid -nm m N K m tid Z Z V) m 0 cn O Z �m V W 00 m m Cl) Z C O m :. � d O ro � w ran H � r W 1 %-D n�o N a% 0- REC�-)VED �•� City of Federal Wa • APPLICATION FOR BUILDING_. ff MIT 7UIL-DING fJi=F'3'. j PLEASE PRINT Q U T H 5�,(e e� Profe j�I U JGI} g APPL/CAT/ON #; SITE LOCATION Address Gl�lo 7W SoA\ 3y8 «j TH Tenant (if known) Lot # Assessor's Tax # Building Owner Name Address ' E State yZp Phone f Work ns7A ��p� Fl rr Pro echor, JI Hiv mc-"o m Name (F,M,L) Address City Contact Person Day Phone bmpany Name ! `�' LOB Address Z$6ZI PaCF1L HC1 h City LIC 1`4 { Wine Contact Person Contractor's # (card must be presented) Name Address City Contact LEGAL DESCRIPTION State Zip Other Phone Fax State l„ J 19 1 zip 9 8003 Phone. 33 p 9L pL Fax Expiration Date l D Verified ❑ Yes ❑ No Hz- Lks� �� : St Su;+c, I0 Z n+ State 111W Phone Zip �}I Fax Please COMPlete RBVerse Side CD0492 (Rev 41931 STRUCTURE I —'sting Use �' .posed Use Permit includes: u Building ❑ Plumbing r. ❑ Mechanical Type of Work: ❑ Residential © New ❑ Remodel ❑ Number of Units ❑ Commercial ❑ Addition ❑ Garage ❑ Shed Enter 1 st Floor + �Laq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area Water Availability ❑ Sewer Availability ❑ On -Site Septic System Availability ❑ Project ))slid Zoning Lot Size Existing Bldg VA(ur LENDER FNa-e MECHAidICAL CONTRACTOR Contractor Name City TA. C.C. MC, Contact 13A Fo r-Sb Iff-C ( License # PRT R r F P Ogq(Y PLUMBING CONTRACTOR Contractor Name City Contact License # PLUMING FLYTURE .COU T< Address State Zip ❑ Other ❑ Deck ❑ Other sq ft sq ft S. ddress any -F� �#S'" Adc C.:� G State LJA zip RaKZ,r1 Phone Fax C ZD63 92-6 -ZZ90 42G63 q2-L 6150 Expiration Date MOIL Verified ❑ Yes ❑ No Address State ZIP Phone Fax Expiration Date Verified . ❑ Yes ❑ No 4.1 �V � x Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains Total Fixture Count'::.:::. MECHAMCAL uNTr: coUNT- J� Fuel Type (electric/other) Gas Dryer i Air Handling` = 10,000 CFM 15-30 Tons Length of Gas Piping Mange Air Handling > = 10,000 CFM 30-50 Tons Furn <100K BTUs S Log Unit Heater 50+ Tons Furn > 100 BTUs"` +-P&s Miscellaneous Fuel Tanks Gas Hwt Hood Boilers Above Ground Conv Burner Duct Work 0-3 Tons Underground BBQ's Wood Stoves 3-15 Tons Total Unit Count 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 owi 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, expense., 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: ! i