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-
- BUILDING DIVISION
G 33530 First Way South -
� L E C E I\!E D Federal Way,WA 98003
661-4000
OCT 2 61998 Fax(253)661-4129
a1" -'iDI•r�Nv.ertilatTW. AY
. G DEP
APPLICATION FOR BUILDING PERMIT
PLEASE PRINT APPLICATION # 1 LO�g— 07 4 3
Iii' ;a * i :::iiii::.:iiii.:;:.:.:.;:::.;:i::.»:,:; ::> Address '7 4.y7 Pr[c i,ccc 14.1� ,
Tenant(if known) /� Lot# L Assessor's Tax#
�A lli-- ilk'::) ( dl.
Building Owner's NameAddress
�4-O41 mt f
City State Zip Phone
Nature of Work r.,)Fp=/%e t l.S i/ 4 j.i. i)
Name (F,M,L) )
tc;?, iPtii1 I, Ai l
Address y 1
ix „..) &.,...t. - -$T-,-,, '
City ', -C a tr'(.
State fr(.j ot Zip ( / t.
Contact PersonDay Phone Other Phone Fax
i✓A (
.2 ) "7/3- S TseA f/--
l5 A--`i� 7.S j • ,'W 14';V
Company Name Z )t `, ti
%d ess
Cityi
State Zip
Contact Person Phone Fax
Contractor's #(card must be presented) Expiration Date Verified 0 Yes 0 No
BVkkBTECT::.;:.:.:.:.:.:.:.;:;;:.;:.;;:;.;;:.;:...;:.;:.:.:.;:.;;,<.:>::>:><>:::::>::>::>iM
Name it.L/V,L,
Address
City
State Zip
Contact Person Phone Fax
LEGAL DESCRIPTION
l.t 4 c.-L.L '--1 c-,7 e--
• Please Complete Reverse Side •
Existing
Use '9
1 '� Proposed os
ed Us
e
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
0 Commercial 0 Addition 0 Garage 0 Shed 0 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 Project Valuation $ /f.�c✓-
Zoning Lot Size Existing Bldg Valuation $
LENDER <':< <iNai i< iNiNg«> < > ;M:
Name Address
City State Zip
..;.;.;::.;.;;;; .;.:;;;;;;:.:.;:.::.:::::.:.:
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
PLUM :>::>BINGXONTRACT.OR: imimimiNiM
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
i .
ka t
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains •Tota) Future Count
I� E411 � �7VC�tt� #
MECHANICAL EVAL
A
TION ONLY
$1 . : ,,.:::.:::::::::::::::..:
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.
4,-
Owner/Agent---
L:- •-• Date: /./ -. r`)
f
BUILD
EvLD 126
P •RS
EvEo 8!28/97
3Ep-23-98 WED 09:32 ABC-PACIFIC FAX NO. 2848621 P, 02
+ .
\•
NORTH
SCALE: 1H- /DO
I
Sou, h /irie of The North 2D0feet of the SEX HE%4 /7-2/-4 !
p /O'WaAer�Sm 7� I �.ok.
�' N89°43'47"YY 6/2.7Z' --� D
-..` 33.3/'
�`; ..._.. Sfi/ 1.0/ /ine ��r
ProposedN.
ed
o i �° !tet Zi , 'Q
I o o
443 NI- L _.- -IN r i , $ '
oO i I .5"'easement; '
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0 Approval is hereby granted subject to:
0 Disapproved because :
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