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V'� 7
A
� . fit% PPLICATION FOR BUILDING PERMIT
PLEASE PRINTV APPLICATI011) #
BUII,DING-DnS%ON
33530 First Way South
Federal Way, WA 98003
(253) 661-4000
Fax (253) 661-41.19
•Address
Tenant (if known) / /
Lot #
Assessor's Tax #
Building Owner's N
Address S11,A Ve .
City 1�G s;ru� </`� � State W
zip ?U
Phone�2596S— sp%
Nature of Work S a F'
FEDERAL WAY BUSINESS LICENSE #
Company Name
Address
City State Zi
Contact Person I Phone I Fax
Contractor's # (card must be presented) I Expiration Date I Verified ❑ Yes ❑ No
LEGAL DESCRIPTION
X
sting Use
;oposed Use
Permit includes:
tv Building
AR Plumbing
Mechanical
0 Other
Type of Work: Aff Residential
❑ Commercial
'❑ New
❑ Addition
A6,Remodel
❑ Garage
❑ Number of Units
❑ Shed
10 Deck
❑ Other
Enter 1st Floor GC� sq ft
Area BasementC12sq ft
2nd Floor
Decks O
sq ft 3rd Floor
s ft Garage
sq ft
so ft
Existing Floor Area _
Proposed Total Area
_ sq ft
sq ft
Water Availabilitri Sewer Availabili
❑ On -Site Septic System Availabili
Project Valuation
$
Zoning
Lot Size
Existing Bldg Valuation
$
Contractor Name Address
City State
Zip
Contact Phone
Fax
License # Expiration Date
Verified ❑ Yes ❑ No
Contractor Name
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
w-- ---------------------
PWWING FIXTURE CQIJN:
Water Closets
Sinks
Urinals
Lawn Sprinklers
Bathtubs
Dish Washers
Drinking Fountains
Other
Showers
Electric Water Heaters
Sum s
Lavatories
I Washing Machine
Drains
Total Fixture Count
F ------------r-::- :.., :: r :.:,>: >: .:- . .• •
1`ilCNt'C4:IT,? >:>:•:..::>
r
Syr l o i — 60
MECHANICAL EVALUATION ONLY 5
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
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 comca to the best of my knowledge, and fiuiher, 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 maybe made by any person, including the undersigned, and filed against the Cityof Federal Way, but only
where such claim i",
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.
+r
� Owner/Agent: ��rdrrr50 � C Date:
n, v:;., areeiw
;-: Irt ;
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40
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1
SETBACKS & FOOTINGS
Date By
2
FOUNDATION WALLS
Date By
3
PLUMBING GROUNDWORK
Date By
4
SLAB INSULATION
Date By
5
FOOTING/DOWNSPOUT DRAINS
Date By
6
UNDERFLOOR FRAMING
Date By
7
SHEAR WALLS
Date By
8
PLUMBING ROUGH -IN
Date By
7
GAS PIPING
Date By
10
MECHANICAL ROUGH -IN
Date By
11
FRAMING
4
Date By
12
INSULATION
cl7--
Date - _ By �
13
GWB - 1ST LAYER
Date j^� �' BY C
14
GWB _ 2ND LAYER
Date By
15
SUSPENDED CEILING .:.
Date By
16
PLANNING FINAL
Date By
17
PUBLIC WORKS FINAL
Date By
18
FIRE FINAL
Date By
19
BUILDING FINAL
A
Date .Z �0 By
720
OTHER
Date
CDO193 (Rev 4.'97)