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BUILDING DIVISION
cirlYho411
33530 First Way South
-- EL7EStF-IL Federal Way,WA 98003
�� FIY ' - (253)661-4000
Fax(253)661-4129
SAN 7
criy 9F:Feu APPLICATION FOR BUILDING PERMIT
BUILDING DEQ
PLEASE PRINT APPLICATION # 6-T
NO Address3
i Z
Tenant(if known) Lot# Assessor's Tax#
4.1‘101t.e-,, S 2 IS /7o.- cl/o
r Building Owner's Name Address
City State Zip /� Phone
Nature of Work A /3 6 I 5 �'Y4 d if.� ,O .C fa 2 , , t),,-/;re N•e !f PLA
APPLICANT <'?IMEN` >'Minig <:
Name (F,M,L)
Address
City State Zip
Contact Person Day Phone Other Phone Fax
FEDERAL WAY BUSINESS ESS LI
CENSE
�
3 s
Z
Co pang
Name /j
Address
36 /f s? f
City /ilii < S LA VI- dc) State &1 /7C Zip �f A-0/0
c
Cont Person ` // Phone Fax
� U�vl�ti ,2�J ��tLd�� �2� Sl1 dam- ZPi-2S - lid 2- S zv6-2 Vd6 7
Contractor's fi(card must be presented) Expiration Date Verified �2 1es 0 No
i-161“..y.be,
NGk. o'1''1zoo 0
ARCHITECT'>< >'> < '> ' ' >'<» '> N
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
n
Use
'w�. ..UC .........:..,,.....::•:::;;::.�.�;.�:.�:::• • :::: ti9 Us posed Use
Permit includes: 0 Building 0 Plumbing 0 Mechanical ❑ Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units 0 Deck
Commercial pit Addition 0 Garage ❑ Shed 0 Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability 0 Sewer Availability 0 On-Site Septic System Availability 0 4• Project Valuation _S 6 s O
Zoning I Lot Size Existing Bldg Valuation $
........... .
.........................................................
Name Address
•
City StateZip
;''
/
MECHANICALCONTRAil Artommin i'
Contractor Name Address
City ;,tate Zip
/
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
111 ifi`:i,:x:i;i:?>i i*i:ri is YT:i:i:i:."i:�;;i::i ` :[ [ <iir >i?
Contractor Name // // Address
City State Zip
Contact Phone Fax
License # / Expiration Date Verified 0 Yes 0 No
/
PLUM BINGMIXTURECGUNTMEMME
Water Closets Si s Urinals Lawn Sprinklers
Bathtubs ish Washers Drinking Fountains Other
.
Showers / Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
::i%.i i*ii:: :: :ii: :y:i:ikii ,`isi Ni.N i:...,'.imam #:ii`'
IMECHAN.C. LiiITNITiC U V. :::::::::. . MECHANICAL EVALUATION ONLY $
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 HwtHood Boilers Above Ground
i
Cony Burner/ Duct Work 0-3 Tons Underground
BBQ's f Wood Stoves 3-15 Tons Total Uhit Courjt .... ..
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.
r •
Owner/Agent: Date:
RD ILO INC APP
REVISED 8/26/97