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•
1 SETBACKS&ROaTING,S
Date By
2 FtIN !AIaN WALLS
Date By
..................................................................................... ..... ........
......................................................................................................
3 PLUMB1NG
...........................>f..R....OUNDWORK..............................................................
3
Date By
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................................................................................................
4 SLAB tNSUE:A'[�CJN
Date By
................................................................................................ .
5 FOQ.T .G JDOWNSPOUT DRAINS
Date By
6 UN[3ERFLt Oi FR:AMING::
Date By
.................................................................................................
Date By
8
Date By
9
Date By
................................................................................................
10
Date By
11 FRAMING r-1 f� — j O — Z. — C1 Gt.-`�
Date// 7 Qz 4' By
12 INSU CATION
Date/0- 2 ?— I S By Gc.�
13 GW[3' :<f$1 :I.NYE1
Date//—/— mo' 9 By Gc,4./
.................................................................................................
14 G�W#3 2N....LAYER::::::.:......
Date By
15
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Date By
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16 pLANNINO f=1NAL
Date By
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17 PUBLIO:>WORKS:FINA.kL::ii>::::>::::>:•:i..g::::>::::>::>:: >:<::•=]::: :
.................................................................................................
............................................. ...............................................
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Date By
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18 FIRE.FINAI <`< ;:.'. ....::...
Date By
............................ ....................................................................
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19 BUILDING FINAL
Date „— ScBy C[�
.............................. ..................................................................
zu ....................................................................................... .........
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Date By
CD0193(Rev 4/97)
BUILDING DIVISION
"r'°r G 33530 First Way South
' J Fit
_ Federal Way,WA 98003
(253)661-4000
Fax(253)661-4129
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION# Igo ' 0 /.(5
Si re
to address
Tenantna4 Lot# -1 ` -461 L�s�r�SOtf# `iogZ .....,5zaL-rr�trs Z-
ile
Building V Owner's N me Address
awt �s`` p n ci 3 -11 z 1 C,L C, 9soo SC4.) aezr60r i6/,'0 _De baa
City PC,ejlei'nri State 0k Zip 9 ?--Z9 Phone(SO3 l< -'/f3/
Description of Work ,IJeed ko vei.e,tve,, Fe if r".1` frv- c --t-CNc e t.t k G*c c+
weXe_ otiread cc'lvP--rt-e,( -kr) d.we. titn5 Lin tis .
— S-
r
1 O
t
Name (F,M,L) n
'c (512-e 4.1 e - ..,,,r1,.,' �C-�Gt L l
Address ��
City Po/1T-CLIb--2 0 State a,4_, Zip 9 2-2/FJ`
Contact Pers Da Phone Other Phone Fax
7 �) , sz� �a ms //,3/ --- . Fax
5153 ) t -9.3
(7.a3 6
ituilbliSta. .. .NTRAtTeR...........................:. Federal Way Business License #
Comp Ne
Address
City State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
A) C!UETE.C. ><> >��' Ms< €> ::<:
i> .;< M:ig:Mi
Name
//v
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION s e r r
Please Complete Reverse Side
E— -,;—Lo(
-4ff:.e.::..:::: :sisi;:iiii: iiiiiti . i2Fiiiiit:ii::<:::i::'i:a:i'i:i�i
'1>.i<>: s:a»>:isii''_>#::::»»»»::;>::»:»:<: Existing Use2. Proposed Use
Permit includes: 1 Building ¶�Plumbing El Mechanical 0 Other
El //�C
Type of Work: Residential 0 New t� Remodel #of bedrooms 1 0 Deck
0 Commercial ❑ Addition 0 Repair 0 Garage 0 Shed
Enter 1st Floor -3••5.-C1 sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area �j D sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area 3- sq ft
Water Availabilitlo Sewer Availability On-Site Septic System Availability 0 Project Valuation $
Zoning Lot Size Existing Bldg Valuation $
............ : . . ........ For new residential only- Proposed selling cost: $
Name /4 Address
City ` State Zip
EC`.HAN CA: CCO>>:_ RAC. .»inin:
Contractor Name // n Address
City ( V l/ �) State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No -
•
PLUMVM B NG
ON R `CT CC `>`> ?<>
X311..�iA. ...t�R............................
Contractor "---" 477 fQ lit 1' (� J?l, `Address
City State
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
L M B.NG Fl?CTiiRE..GdUNT ..............
Water Closets - \ Sinks -- ` Urinals Lawn Sprinklers —
Bathtubs ' Dish Washers — i Drinking Fountains krj,4- Other
Showers ! Electric Water Heaters 6 Sumps ,U 1A-
Lavatories - 7ti/lI,- I Washing Machine — 1 Drains -'1.,_fs Total>;Fixtttre. ount
e
O
a..✓9
C,
I{IfE €A..GAL.UN....C��J111"�`........................ MECHANICAL EVALUATION ONLY $
Fuel Type (gas/ar/other) Ga(bryer Air Handling < = 10,000 CFM 15-30 Tons
Length of Gas Piping Range -ECet,b_,L Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Gas Log "4i Unit Heater 50+ Tons
Furn >100 BTUs Fans —64411rex""(e tksf aMiscellaneous Fuel Tanks
u. D.
Gas Hwt ' Hood -vim, Boilers Above Ground
Cony Burner Duct Work 0-3 Tons Underground
BBQ's — Wood Stoves 3-15 Tons Totab:Untt Count
'l✓G fjacQ i'-‘).)1D" i•)rifl IV1/4-S •
DISCLAIMER: I certify under penalty of perju at 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 • oh pe 't applic.;on is made. rth/agree to save harmless the City of Federal Way as to any claim(including costs,expenses,and
attorneys'fees incurred in investigation.•a defense. such. - ), inch •. .e./f.de by any person,including the undersigned,and filed against the City of Federal Way,but only
where such claim arises out of . reli ce of the ci' ,). ud•.../'..-
�g•„�ffrc-, ployees,upon the accuracy of the information supplied to the city as a part of this application.
,
j
Owner/Agent: / Date:
auirOinG.A W
REvsED 5/18199