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M CO 1 G') 3 O m m n m .4 3 m II M II 3t rrlC Z ti -4 3C M n 11 s ii 3! N II r• CO bi .x O rn €! p II 3 'I it IR '--i Ii - z 0 II II �”t 4) I11! . < 11 11 n n IP 11 O k i 0 Ii II it €i • r 1 6q @A 6.7 Eif6Fs II 31 il ` 1�.� ` 11 ii II II ` �-.` n O P 3 i-= %.0 11 9 it 13cd.. H .-C ca, 11 11 ti CO V II GO 1� 1'-. 00 V n n 1! 31 - n 11 t O \Si n Cr. Cr! O a n ti II C D ca Ca C) Ca H 11 it 0 r^ C.., I7 11 III ill 11 BUILDING DIVISION °n'°F � 33530 First Way South EDElZFIL Federal Way,WA 98003 Vv FIY (253)661-4000 Fax(253)661-4129 APPLICATION FOR BUILDING PERMIT PLEASE PRINT CITY OFF '=' At i'ria APPLICATION# J�"1 -0 48 nFPT. Site address '.33/0o eile- 4/A Alaj \S' Tenant name A fG#0 f f J je� Lot# Assessor's Tax # Building Owners Name J Address �ry/�1/Ali' afrfh r 3. 166) city y?-/rq A SLI State /�,/ / Zip 91QQ� Phone Description of Work J ,614i/I /1/111/1* Name (F,M,L) Address / Si5k • City State if- � Zip 9S 7friact A `% � Day Pho fl I TA� Other Phone F�4 ,tu Pb� yAcii � Federal ay Bus Hess License W i Li n # Company Name - Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No Name Address City State Zip Contact Person Phone Fax LEGAL DESCRIPTION • Pl•. • .mil• • R'v•i • t I • <' ExistingU Use Proposed Use Permit includes: Building ❑ Plumbing ❑ Mechanical ❑ Other Type of Work: 0 Residential ❑ New 0 Remodel ❑ #of bedrooms ❑ Deck Commercial ❑ Addition ❑ Repair ❑ Garage ❑ Shed 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 Project Valuation $ I" 657) Zoning I Lot Size Existing Bldg Valuation $ • --- , ..._ � �.:_'» i�ENL?E�>>»> >>_' >i»> >>>><<»<> » > > <'>.::. For new residential only Proposed seIl'ngcost: $ Name Address City State Zip ........ .........................................?]:i: .................. ...... ME ANI A ONT CIVT E Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date -- Verified 0 Yes ❑ No ............. ::]i:.................. ....... ::::................................. .. . ................. .............................. ............................ .................................... ................ ......................... .. . ................. .............................. ............................ .................................... ................ ......................... PLUM Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified ❑ Yes 0 No - .. ................................................................................... .. ..................................................................................... . .................................................................................... . .. ................................................................................... PLUMBING FI!XTUR>A<COONT<;EME:: Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains TtttalFixtute Count ................K:i:..........;i:i: ..................................... ......M::::: ............................................. . ........... . .................... ........................................................................... .... ...... ............................................. . ........... . .................... MECHANICAL EVALUATION ONLY $ Fuel Type (gas/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 Under.round BBQ's Wood Stoves 3-15 Tons Total Unit Cottfii. .: .. ... . 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: Date: _- Hcvrsco 5/18l99 ..••: .: - :•::••iii.:..: iiv'..:. �i{hi{•:{hnvii - .::{h:$:vi.: .:.:...::•,J, :•:••:•v::: :• hii i: •iiii:•:{:i: ..s•{•.h.n..::: . ..s......:1!;: :...v;;:iT..".....:.. ::nv... ....:r....... :..:}.-.... s........:::•M.... v...:...... :vh.,v,•..:.............................n...:..........:v...v.•.v..?.. ...:.v.:.....................x:i:.v::::::: ::••:nv:::::v:x:........:::•:viii:4:{•i:ii S::vi:.•.•:•:'{h:•iii:ti4i:iii::.• i.:•i:{:•i•i:tih:.::::v :•i'•i'{ •ii'•;.:hii v:ti. \v N . -. {h� mow. 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