99-103573 h 0 - d -0 -0cn Nmwn
TA 0
m , CN , N m D cn ,w♦
1Z • m T Z T It- D V1 T Z O ^ m TCO -, c.J
0 x T O.--. O N N Z71
m 0-, m m l / > VV// Q
rt. m "canon. '- n w . m rn O
o '< N m m r z r co D -< n r 0 T m
o x < vm Dmm •o rF -I
D mN NA -1
Z T I -mi 3V .p Cx w O7J N V)
o J 93 -< A Q 3< N D mm m O < Qm J '0m93 m OCT Z CA
m m � DX C
• >'< D3 cli o N W CO CI) r
m . •. . •. . O Z7 -1 IpIp CO 0C
A JJJJW • O
OD OO VI U ,..
D Z ~ Ip OSS
> 1
•
o b o mo
C m m o vi 1-3
N 0 x
z 1 R. 1 D:1
I O C C
m -' C CIm iiin
0 0 J py .^ li
7C CO M
m
m
j r0 N.
lit
m r H h)
711/
Dm Cl N
Z 0
0
^ 1
CI q
7o 70 1.4
T \ .. m-i vm - w �
mmn H -•73Na
O- m or DDM7J m ` ,xi
COGI 3
"d
-1 co 4)m N 1-1
n
m 0 \, o N >X �
0o D H N v1 z -1 t'1 Xn
mi
u 0 H M 7o b! -I
o T z _ XI
-s
`;' CO m �.
m '� o wIli -I
Z ♦�,
z c 0 xf
( V+
r z 0 `� m /�
m m 4 -I U)
O
m Z H O
D 0 x z
O 0 � m
N
> 0
m m � H w �
• N co
r D V
; m
W o CO Xi
r
-1 T m
n o m z
-1 m v
-� D N T
-,A -< r T T T-V .
- v r 70
o T A.'O co a MINN
m m m m z
m v
-n N m m A x
T T m 3
o vv -I m
m -C-I 71
`"
T T N
> m T N m
r m m C m
D m
Z
D m
-< "U
XI m
m X
o K
C 69 69 69 69 69
m CO Z
m o rwow C 0
z rn
-I ..r- -•--o iv 0 .. ,�
cn as v100—
I- 0 °d
r co 4O W o
omo -<. Vo �.
m it. 1 v
71 14*"••• 0 J-J
VO Au
a„a G
• City of Federal Way •
v\) PLICATION FOR BUILDING PERMIT
E APY waz,
SEP-1 51999 ___ /�
PLEASE PR/NT APPLICATION #: F41 0014
SITE LOCATION Address .34 C�3 ST i� AV r= s
r tlil E3zP�i:..
Tenant (if known) Lot # Assessor's Tax #
—150A5 i — OV-50
Building Owner Name= NT Address
Si<E)JY Snv�C lc fir., 1�t _tiIJAY 203
City h Ri,6t44,1n State W�� 1 A Zip QplO 133 Phone \ \'
Nature of Work C D / `E LOCATE (2,(::;) SpZ/JK. l..(✓PtS �J12. �w TEi 4/V
PPLICANT
Name (F,M,L(
Address
2- gi> u LSU I-rte 6
City pcv, t�l C— State' k Zip 6Y504 7
Contact Person Day Phone Other Phone Fax
1.1\0 Amt .fir: 7 F.3"g — )Z4 Pj ZS3 ? -o/13
,tUILDING CONTRACTOR 1
mpany Name
Address
City State Zip
Contact Person Phone Fax
Contractor's # (card must be presented) Expiration Date Verified LI Yes ❑ No
1RCHITECT
Name
Address
City State Zip
Contact Person Phone Fax
EGAL DESCRIPTION
P/ease Complete Reverse Side
CD0492(Rev 4/931
___---4?-
STRUCTURE •xisting Use Proposed Use f
Permit includes: ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New ❑ Remodel 0 Number of Units ❑ Deck
❑ Commercial 0 Addition ❑ Garage ❑ Shed ❑ 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 ❑ - On-Site Septic System Availability ❑ - - Project Valuation S -
Zoning Lot Size Existing Bldg Valuation $
LENDER
Name
Address
City State Zip
MECHANICAL CONTRACTOR ee-E"Sfleltil& g.
Contractor Name Address
-F12e- SYc4reit4,5 1aJP:€51— 4q F ac*JT g U 43
City t"t'N--1 (� State w Zip 9 4 7
Contact Phone Fax �"�
L ti A _A NO _ iz Zs--3 -7 -ol f 3
License # R v-es1.J i 4 c R ( Expiration Date 1c'/9 G, Verified ' Yes 0 No
PLUMBING CONTRACTOR .I'
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture Count
MECHANICAL UNIT COUNT MECHANICAL VALUATION 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 Hwt Hood Boilers Above Ground
Cony 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 correct to the best of my knowledge and further that I am authorized by the o',
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,
out 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
:::f:nt:
nA`/.y�fJ//J�jt�''��E'" ,2,/�!"' �� Date: . 1—411