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BUILDING DIVISION
7, 33530 First Way South
ns Federal Way,WA 98003
RECEIVECRECEIV ECI (253)661-4000
Fax(253)661-4129
OCT 2 9 1997 OCT 199
ao
CITYOFFEDE�AL� E hO FOR BUILDING PERMIT
BUILDING DEPT.
PLEASE PRINT APPLICATION # ap 3 (0 g'--)-
>< Address
Tenant(if known) Gi "r/
i,cL 5 Ibcf _r--- Lot# Assessor's T=. • -_
Building Owner's Name /Am ,,, . ,a, Ait i Address
awio i -e 1 • - 40 ,001.,441, 17,iii % �� 4,0*?.., !"r„�" 'y=,
City d-') I State iq.:J� ` Zip v��� '7.-; Phon: '417' W ,'A
Nature of Work (.Ct-ht) i/I K ,s4`G vi- _, y5j ,v7
:Ar::$ �:::::' :?':.'„: „„„ ''' #: 5,':::: ::: ' : ': :':'
Name (F,M,L)
A4,7„..".„4...,,,,,, S-,/
Address ) J✓ VQ/47 `�
City K-Lt/,- State 4
Zip
troycf
Conte arson Da Ph ne Other Phonea-►T� r 1� 0065 5- 1671 exf�d� Fao
57a5
iiiitthiWaiiiiiiiiefiiiiMMENE
Company Name /V6 ft.„4....c.„7_41_, 5 t......,_,...”
Address IJP /; /w
�� �-L:`i� ltd. /!/ G/,
City (/L_ T / State �.4 �y,Zip CID61i
Contact Person Phone �xr��/Fax
Oa_r-e cf -e..,r r,_sb #, a ,S`2.5/t 7/ ate- 5-7) 5
Contractor's #(card must be presented) ,i y� q� Expiration Date Verified 0 Yes 0 No
Name
Address
City State Zip
Contact Person Phone Fax
By6 06A_e_r0
E N �j - ,i--
. r
' /� i/
5 is• Li, a - 7 c✓ii' YL 7Y c
c s-plf- '7 S3
• Please Complete Reverse Side •
Wad
M Existing Use Proposed osed
Use
Permit includes: 0 Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New 0 Remodel 0 Number of Units_ 0 Deck
1611- Commercial 0 Addition 0 Garage 0 Shed 0 Other
Enter 1st Floor sq ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor AreaG76 Q sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area sq ft
Water Availability 0 Sewer Availability 0 On-eSite Septic System Availability 0 Project Valuation $ J . 6 6 O.,NC
j/
Zoning I Lot Size ('pgZ,3 Existing Bldg Valuation $ 7
........................................................................................
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LENDER is?: :::::: ::`;:: ::: :::: ::':: :z:`
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Name Address
City State Zip
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Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
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PLUM
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Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
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0.111)M BINGTIXTUReCOUNTniimim: :
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
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Lavatories Washing Machine Drains Total Fixture Gtiui Y
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1 :11/gN10:AV: 1111.'1'0 1;1111'1'.. 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
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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: — Date: /L 4— , ,:'-/
7 REVISED 8/26/97 . • I