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SETBACKS;& FOOTINGS
Date By
FOUNDATION WALLS
Date By
..................................................................................
..................................................................................
..................................................................................
..................................................................................
.LUM6ING`GRGUNI�Wf FIK
Date 7 '), . 5 By RA/
UNDERFLOOR FRAMING
Date By
..................................................................................
..................................................................................
..................................................................................
..................................................................................
SHEAR WALLS
Date By
PLUMBING:ROUGH-IN
DateOi j 5 By�h�J
GAS;PIP1NG`.
Date By
..................................................................................
..................................................................................
MECHAI+I1Ca►L ROUGH-IN
Date By
..................................................................................
..................................................................................
..................................................................................
..................................................................................
MECHANICAL tOTHERI .
Date By
FRA►NIING •
Date/.,2 /%qS By f,Ll/i/
INSULATION •
Date By
•
GWB- 1ST''
LAYER
Date By
GWB 2ND LAYER;
...........................................
...........................................
Date By
SUSPENDED CEILING
Date By
PLANNING,FINAL
.................................................
Date By
...........................................................
...........................................................
........................................................ .
ENGINEERING FINAL
•
Date By
FIREFINAL
Date /- 41-9'li Bv,S. 5,
rBU1LING FINAL /
Date/— 5- By,41/1/
OTHER
Date By
7 OTHER
Date By
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[STRUCTURE •sting Use •oposed Use Station
Gas Station
Permit includes: kl Building (23 Plumbing P.9 Mechanical ❑ Other
Type of Work: ❑ Residential ❑ New Remodel ❑ Number of Units ❑ Deck
Dl Commercial ❑ 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 ) Sewer Availability 0 On-Site Septic System Availability 0 Project Valuation S Wfa:r3l,w
Zoning BN Lot Size Existing Bldg Valuation S
LENDER
Name Address
City State Zip
MECHANICAL CONTRACTOR
Contractor Name Address
Unknown at this time
City State Zip
Contact Phone Fax
License // Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name Address
Unknown at this time
City State Zip
Contact Phone Fax
License I Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sinks Z Urinals
Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains Total Fixture•Count ::.....:
MECHANICAL UNIT COUNT
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 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. ''
Owner/Agent:Aa.� `pm" IN Date: \1 \ I Cit _ _