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.s•
SE"t t ACKS:& FI)OTINGS S
Date By
..................................................................................
FOUNDATION 1A►AILS
Date By
PLUMBING GROUNDWORK
•
Date By
UNDERFLOOR FRAMING
Date By
SHEAR WALLS <
Date By
PLUMBINGROUGH-IN•
Date By
......................... .............................. . . .. .................
....................... ................................... ...................
GASPIPING''
Date By
MECHANICAL ROUGH-IN
Date By
.............. ............................. ....................................
MECHANICAL(OTHER►
Date By
....................................................................... .. . ..
........................................................................ ... ....
........................................................................ ......
FRAMING
Date By
INSULATION
Date By
GWB'' 1ST LAYER
Date /0,3/ 5 By %/'iA!
GWII>- 2ND LAYER''
Date By
SUSPENDED CEILING
Date By
PLANNING`fINAL
Date By
ENGINEERINGFINAL.
Date By
FIRE FINAL
Date By
BUILDING FINAL
-CS',Ve
Date`f /` 1 By/f4N
OTHER
Date By
OTHER
Date By
CD0193
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• • RECEIVED
City of Federal Way
L OCT 2 4 1995
APPLICATION FOR BUILDING PERMIT
GIT BUILDING DEPT.AL AY
REVIEWED UNDER 1994 USC
PLEASE PR/NT
APPLICATION #: DC/3 i" R-?1;;
ISITE LOCATION IAddress r3s/2Q ,A_cd vQ. Sui�C
Tenant (if known) Lot #
M6 811-G114-1 I Assessor's Tax #
X Building Owner Name
�3R(A-Ai Mcr "IA/
( /LL/AI 13 Lid• 33x/Address ".9-Cil/ lffid Sc, F,E6‘s?.4L k,A/?
City FE tZ4 -L y,A4_1/ (State W,4 Zip 9gd J I Phone
Nature of Work „L " �?yy jy1 l�f?G!�� � 217,eixter Watt)
APPLICANT I
Name (F,M,L)
MnR /
Address
331 za P4c.i1 . go .
City F 4/_ q--/
14k State /. I4- Zip 9 s o d 3
Contact Person Day Phone7`i--5‘`f
7Other Phone
/44 6r4—'6r4—' !3 ! `i--5/y Fax
y.Z�._S' Lz--S ,S7N—s4y8
BUILDING CONTRACTOR I
Company Name
Address
City
State Zip
Contact Person
Phone Fax
Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No
ARCHITECT 1
Name xio ti -
Address
City
State Zip
Contact Person
Phone Fax
LEGAL DESCRIPTION
Please Complete Reverse Side
CD0492(Rev 4/93)
STRUCTURE ixisting Use 1� •roPosed Use `� ---1-71--1 C___
Permit includes: ❑ Building ❑ Plumbing ❑ Mechanical ❑ Other
` Type of Work: ❑ Residential ❑ New Remodel ❑ Number of Units / ❑ Deck
XCommercial ❑ Addition ❑ Garage ❑ Shed ❑ Other
Enter 1st Flooq'ft 2nd Floor sq ft 3rd Floor sq ft Existing Floor Area rj(Q d sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Areal 5-6;7 eni sq ft
Water Availability y Sewer Availability k'' On-Site Septic System Availability CIProject Valuation $ 9 ell"Lot Size Existing Bldg Valuation $ ,''`�'T1.
LENDER
Name pj n/0LT- Address
City State Zip
MECHANICAL CONTRACTOR
A___Contractor NameN, , Address
City State ' Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING CONTRACTOR
Contractor Name A Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified ❑ Yes ❑ No
PLUMBING FIXTURE COUNT
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavato Washing Machine Drains Total Fixture Count
MECHANICAL UNIT COUNT
Fuel Type (electric/other) =as 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 Bur • Duct Work 0-3 Tons Underground
BBQ'- 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 reliant 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/Ager �'Date: 1 0721/9r—