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Date By
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Date ��rrBy
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Date By
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Date By
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City of Federal Way
•
,RE
CEIVt APPLICATION FOR BUILDING PERMIT
JIB 0 61994
PLEASE PAINT 1 pL WAY
APPLICA TION It: A 1J
` att� �;s: ; ' 'u' �^b;. ,, 's'''•„•,:>}'” Address 1 lin Avenue ,ou , uite
1 ,
y�2irrq.
TenpnL((flcMutual Insurance Society Lat# AY bbU1-0U45-07
Building Owner Name Addres,C/0 Continental Real Estate Management
Connecticut Mutual Life Insurance Co. . 601 Union St. , Suite 2000
Ciry7Seatt e, state WA. mp 98101-2326 phone 389-4460
Nature of Work Tenant Improvements ---ere (,l(,1,kcc
. i' �, '. �'y1iAr'�;}�,�•? S; Y�,�{�';,L;s',}{'xF'�}�;t,yR.�:.ek`; ?by}G.'r}:R�r
> , ':'.}.'.}' k:vr'E ;}` ..Ai:ik: •'�iS,:,3,;{;,F:}2:�f'�ti:, R�;S,�'OS'v
Name4F,M,L) tontinental Rea Estate Managemen
Ginger Mueller
Address 601 Union Street, Suite 2000
city Seattle,
State WC 981u1-2320
Contact Person Ginger Mueller Day Phone 389-4460 Other Phone Fax 389-4461
Company Name Matrix Construction Co.
Address 3023 N.E. 50th' Street
City Seattle state WA
zip 98106
Contaot Person Rand Grevstad / Steve Mueller phone 524-6804 Fax 524-6901
Contrector's #(acrd mMATRICCustFa88DK be eeentedl Expiration Date Verified ❑ Yee 0 No
iib°A 4 61,1
�[SS! ; ;;.":g' ." '> '
Name
Buffalo Design Inc.
Address 1501 Western Suite 500
Cley Seattle
State WA -_Zlct 981U1
Content Person Lisa Scribante Phone 467-63b6 Fez 464-0879
LEGAL DesCRIPTION
Wst Campus Office Park DIV 2 Lot I KC Short Plat NO 981015R REC
NO 8112170665 SD Plat DAF - ALL
LOT 4
peafse Complete Reverse Side
• • CD0412(Ra.di/B3}
..... tca5'a„. {.`}s;i:4'%b'V.' i.,. ; AisiSi••••,•:i yyfECstiUe
Office` s" r '° :iiiM:ii fi "ming Proposed Uee
Permit includes: Allding ❑ Plumbing Mechanical Q Other
Tyye of Work: O Residential w O Remodel lumber of Units_ 0 Deck
W Commercial 0 Addition ❑ Garage 0 Shed 0 Other
Enter let Floor 16.510,Iq ft 2nd Floor 16,51 11 ft 3rd Floor sq ft Existing Floor Area U19 eq ft
Area Basement sq ft Decks eq ft Garage eq ft Proposed Total Area 6342 sq ft
}r1{I � • m� Ii' :Water Availability ❑ Sewer Availability0 On-Site Septic System Availability 0 �� RiftLiW•i;.> 'Aa� a � ii.:ISio ' � , iNi
l.
Zoning Lot Size 'ib " ` < }•o-
;��:$�i,lir yin � (.:.ry..r..;.; �.:, ����, ;C'j'Y�� ;.}{'r 1
•
4 }rs ),:iii #riry} < I epi
'i is>kss rigs} s N, M ; )S<;•4;y;
Name N/A Address •
City State I Zip ,
:.F'; � >raN45K
'k ^ I. : y+ . : •C88i
Contractor Name
/7 —.,. -
Address
_
City State Zip
Contact Phone Fax
License I hpira •n Date Vanfiad 0 Yea 0 No
:'''.it.;''':;
< •a ..i.'
•• ..'i yrF O prat.s 1
Contractor Name Address
State — Zip 1
City
ContactPhone Fax '
Licence$ V ExpiratIon Date Verlfl/d 0 Yes 0 No
mer
•
s '}odfl:tir , aryiy • i .. .v ; , ;
Water Closets SinksUrinals I Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water He ars Sumps '
Lavatories Washing Mach! a Drains •?�•'€{t.::'! °Elm r„�€i`
? ..:1;1 .'(,:b'•,s,.,x "'
WA,AAAA'
�M :;i is sH c
Fuel Type (electric/other) Gas D, er Air Handling < - 10,000 CFM 15-30 Tons
Length of Gas Piping Rene Air Handling > - 10,000 CFM 30-50 Tone
Turn <100K BTUs G1(s Log Unit Heater 50+ Tans
Furn >100 BTUs /ens Miscellaneous Fuel Tanks
Gas Hwt % Hood Boilers Above Ground
/
Cony Burner / Duct Work 0-3 Tons Underground
BBQ's Wood Stoves 3-15 Tone y��y y';: . otg '}'u�v1�,,�,�,�A},i .t'r1£°#•r:;''
/
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 art authorized by the owner
of the above premises to perform the work for which permit application is mads.I further agree to sive harmless the City of Federal Way■s to any claim(Including costs,expenses,
and attorneys'fess incurred In investigation and defense of such claim),Which may be made by any person.Including the undersigned,and flied against the City of Federal Way,
but only where such cls rises out of the reliance o the ity,inel%Ing/a officers and employees,upon the aoouraoy of the Information supplied to the City as a part of this
application.
Owner/Agent: Date: /�1 C li:V/V
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