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SETBACKS:& FOOTINGS
Date By
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..................................................................................
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FOUNDATION WALLS
Date By
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.................................................................................
..................................................................................
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PLUMBING GROUNDWORK
Date By
UNDERFLOOR FRAMING
Date By
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SHEAR WALLS
Date By
PLUMBING ROUGH-IN
Date By
GAS:PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
.............................................................. . .. . . . .
FRAMING
Date
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
FIRE FINAL
Date (0,(2,� '� By `
BUILDING FINAL
Date By
OTHER
Date By
OTHER
Date By
CD0193
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ON
BUILDING DIVISI&
`R 33530 First Way Sour
� � -Z
JFI1_ Federal Way,WA 98003
FrY (206)661-4000
c E INI F'D Fax(206)661-4129c
MAR Q A igq7
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION # 131/N1 - }
SggiUMATIORMENSMOMM:,Ad r '
d ess
Tenant (if known) t# AssessoWTax#
\ ' Building Owner's Name AAddress
City rL't1 ,42d4 L -WA-A State 147(/Q Zip ?8//8 Phone eS 7 e/ -/(/ 71('''
Nature of Work EL',420 4 f — Mori ii l re ll6✓li1 i 44,45 's /t 'E7{o7 i-,5,.
::» >` `<'':?> > >'>":. >':<>z�<''[<« »i>€
ii
':A ICAN €>
Name (F,M,L)
Address
1Q. 0 • t C-/ ce3 91-5
City .. A ` 2 A StateGU.) A Zip /dj di _
Conta S}P rson Day Phone Other Phone Fax
SEMONOMONUACitelitEgiiiMiNiMiNi
Company Name
.A%*tfl i,. /N1 en.)T
Address
' City ,---. 1:,--. State Zip
Contact Person
a Phone Fax 4 .,..2.5_,3g7? , .
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
�/ViTiANC - -033 R ,, .— �, — n.y
Name
' .C1j erl JL,tafe n
Address
P6 . 615X ! n
City J'' A) State [1�l'i - Zip 98 O'X
Contact PersonPhone Fax
? :.z — 756 4./p
LEGAL DESCRIPTION b -O� A
jJ
V
Please Complete Reverse Side uv 03
;,; Existing s .< P
Use
Pro ose
d Use
r Permit includes: Building X Plumbing 0 Mechanical ❑ Other
/ Type of Work: CI Residential 0 New it"Remodel 0 Number of Units ❑ Deck
y �� Commercial 0 Addition 0 Garage ❑ Shed 0 Other
JiEhter 1st Floor sq ft ld Floor 6311 sq ft 3rd Floor sq ft Existing Floor Area sq ft
94rea Basement sq ft �jecks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability Sewer Availabilit On-Site Septic S stem Availability ❑ / Project Valuation $ / .
Zoning I LSize 111q)0 Existing Bldg Valuation $ 0'7/cez
L12f_
LENDER: i;Mi>;<':<<< <' > >': ; <''«':<i<€<�<:::
.....................................:...........................:...:.....................
Name Address
/ C.>-----12 --- c->/-4:9-9 roll jp;.c s
City v /F�=4il,�v 2 ii(4 State 7.(„��"'I, - Zip Ci?
2
U /
......................................................................................
........................................................................................
......................................................................................
........................................................... .........................
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 ❑ No
Water Closets vr._. Sinks Urinals Lawn Sprinklers //
?( Bathtubs 0 Dish Washers Drinking Fountains Other11
Showers / Electric Water Heaters Sumps
. .................„,:„„„......................... .........
. .............................................................
..............................................................
...............................................................
...............................................................
Lavatories Washing Machine Drains Tnta1;Fixture count ...
r
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 TatrrlAtmt 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/A a �^girr - ,' Date: , - ..Z / --
B4MLOING.APP
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