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, 4BUILDING DIVISION
«nr r. • 33530 First Way South
A_ F1--1 E i V E • Federal Way,WA 98003
uv �y (253)661-4000
1998 Fax(253)661-4129
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION # P7L B I -OS!5
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,SITEIOCATIONMEMMEMME Address _
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Tenant(if known) B rr/Gl 12e/ '„ Lot# Assessor's Tax#
Building Owner's Name [ `- Address
City State /� Zip Phone
Nature of Work EX�CitJ ? 7Lt..Al PSTE2 PAW
APICA N >'<>< <»>€ >€> ' »'»><<<`` >` >
............................................................................................
Name (F,M,L) '
QpLN C.-
Address Address
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City SE/y77 .6 State VV A, Zip ff /U 7
Contact Person Day Phone- Other Phone Fax
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tultDusiat*ONTRAtTotemainamas ..
Company Name /' p, LT C
Address 3t Ott LE/ ,2_Y WA`(' /U t-.)
City S C A-77 L eZ 6✓ State L✓'9-- Zip cj C—lC...)'7
Contact Person , 5�,?�Q,9 Phone Fax
Contractor's # (card must be presented) Expiration Date Verified 0 Yes 0 No
Va
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`.RC1-tiTECT immig _z>€ <<< <:>< < <>><>
............................................................................................
Name
Address
City State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
•
:s:TEU<.:::<::<::. >>`< `:`'< > >> ' »>»» > > ':>g. ExistingUse
.. 'r ::::::::.:::: ::., ;;;:;:;:;;;;;;:;:;:;: Proposed Use
Permit includes: ❑ Building 0 Plumbing 0 Mechanical Other
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Type of Work: 0 Residential 0 New ❑ Remodel 0 Number of Units_ 0 Deck
L4 Commercial 0 Addition 0 Garage 0 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 0 On-Site Septic System Availability 0 "Z Project Valuation $ ('' ,r"i
Zoning I Lot Size Existing Bldg Valuation $
oE:::.
tEN EM><E '> is < E >> » « < W
Name Address
City State Zip
IllEeliANICALMONTRACTOREMEE
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUM .t 14.7..f.'Denle.si.OU.+.11T....... .............
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
...............................................................
Lavatories Washing Machine Drains Tota)fixture Ci3unt
LVEIr F I##SIL.0V 1NIT 0.U. 1;1;.;;.;;;;;:::;:;.;:.:.;;.,;. 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 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 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 thereliance of the city,including its officers and employees,upon the accuracy of the information supplied to the city as a part of this application.
Owner/Agent: '." 1 Date: L
�r7
BUILDING.APP
REVISED 8/28/97