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PLEASE PRWT
BUILDING DMSION
33530 First Way South
Federal Way, WA 98003
(253) 661-4000
Fax (253) 661-4129
APPLICATION- UK 9'UILDING PERMIT
CITY OF FEDERAL WAY
BUILDING DEPT.
Wool irnrinei u �� � G01 -- /7/_ 1-I-
-...-. -
-- - Site address
Tenant name
%
Lot #
11 n
Assessor's Tax #
%/ S`�
Building Owner's Name
Address moo.
Citv =s �..,� ;; ' `'
State
Zip,` �' .+ i
Phone
Descri Lion of Work %'is b .3 '']^ ;t r'v'S g ,•j:i
Name (F,M,L)
Address
a
Citv
State ij f
Zip 19,72 7
Contact Person
Day Phone
Other Phone
Fax
p,t'-�__—"-•._ - .r
f
J s�i.-j.�.
I CE Cs� { 7 A/ 015 �1-71
sulLONG Ct3 3T - Federal WayBusiness License #
Company Name
Address
I -z-z0
NGy
1 ? f1Vi �
City {Qsd:s
�� ,;.
State f-. ''h
zip
Contact Person
Phone
Fax
Contractor's # (card must be presented)
Expiration Date
Verified ❑ Yes ❑ No
Name
t: (
Address
� qr ,
ultv I State I Zip
Contact Person I Phone I Fax
LEGAL DESCRIPTION
Please %wA=1&te Remise Sim
>
Existing Use
Proposed Use
Permit includes:
uildin
-8'Plumbin
Mechanical
❑ Other
Type of Work: !'r Residential
11 Commercial
X New
❑ Addition
❑ Remodel & # of bedrooms-S
❑ Repair JZ Garage
e4 Deck
❑ Shed
Enter 1 st Floor JL41& sq ft
Area Basement % Cd sq ft
-
Decks S (p
sq ft &M Flear— sq ft
'sq ft Garage sq ft
Existing Floor Area sq ft
Proposed Total Area zi sq ft
Water AvailabilityUn
±9. 5ewer
vat Mai rt Off On -Site Septic System Availabili ❑
Project Valuation
S
Zoning
Lot Size /
tJ 2
Existing Bid Valuation
-
For new residential
Name
- Proposed selling cost: $
Address
State
Contractor Name o
�11V'Ar '�I�i
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
�l1iRA Bi1110'Cf)'N'�#� • '.:. � _- - -
Contractor Name y� a
Cv
Address
City
State
Zip
Contact
Phone
Fax
License #
Expiration Date
Verified ❑ Yes ❑ No
Water Closets
Sinks
Bathtubs
Dish Washers
Showers
Electric Water Heaters
Lavatories
Washina Machine
Urinals
Drains
Fountains
rn S
er
Total Fixture Count.:...
1 1 . J. l #' E7UY:;A:::;;:;:;>:;-:::;=:;<:;::;.:;;,;:;
MECHANICAL EVALUATION ONLY $
Fuel Tyee ( as/electric/other) 5
Gas Dryer
Air Handling < = 10,000 CFM
15-30 Tons
Length of Gas Piping 2-00 f
Range
Air Handlina > = 10,000 CFM
30-50 Tons
Furn <100K BTUs %
Gas Log
Unit Heater
50+ Tons
Furn > 100 BTUs
Fans Y
Miscellaneous
Fuel Tanks
Gas Hwt
Hood %
Boilers
Above Ground
Conv Burner
Duct Work
0-3 Tons
Under round
BBQ's
Wood Stoves
3-15 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 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.
i
Owner/Agent: Date:
BUILD- Ar
REV- 5118199
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1 SETBACKS & FGD INGS
date 2 BY
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Date BY
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Date 7 By +�
6 UNDERFLOOR FRAMING
Date By
7 SHEAR WALLS. :....
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Date.....�� By
8 PLUMBING ROUGH -IN
Date
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Date Q -- I C, BY
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Date cn,, 1 1 - is By
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Date BY
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Date Iyi BY
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Data-0 — BY
14 GW0 . 2ND LAYER
Date BY
15 SUSPI LADED CEILING
Date BY
16 PLANKING FINAL.
Date By
17
PUBLIC WORKS FINAL
Date By
18
FIRE FINAL- .
Date By
19
BUILDIN13 FINAL
�7
Date Z� Cf BY
20
OTHER ..
Date By
CMIN (Rev 4/97)