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10
BUILDING DIVISION
33530 First Way South
Federal Way,WA 98003
� — 1, E0 E IV ED (253)661-4000
Fax(253)661-4129
PP 0 7 1998
APPLICATION FOR BUILDING
PLEASE PRINT APPLICATION# B Ltn V + 'to
3aC, I * ' ::Basi a Address 3\814 — 31A l0 eth •tmtG \-►w`(S. CPbL..C:G. g.c laaro'
Tenant(if known) MULTI Lot# Assessor's Tax#
°t z. 9Lae:.
Building Owner's Name Address
MPSK.- 4:7012.Tv-1 WET 7cocto S>✓✓• Mc>Hawlr-. sT.
City r' t-4 State a t-'4p Zip ct`3 Ofo Z. Phone(SO ')(int l •1•=�e�o
Nature of Work �►c�ra►c: .-2��5 � c�a..oa ��.`.A:c� u.�a+4-t�ia( ' ..os� Cc+�� �-t -cokvw" S
Name (F,M,L) ("L�� (-IQIZTH /�csr
Address
(o 0 'Sw Moo-ldw►t ST.
City TU L OT►N • State Zip ct c"(o Z
Contact Person Day Phone Other Phone Fax
G1Ro►!o For•t 1_ CaoGA.9 .9 yoo C703)(.08d-•72.772...
Company Name
Address
City State Zip
Contact Parson Phone Fax
Contractor's#(card must be presented) Expiration Date Verified 0 Yes 0 No
y.//:��jj'G�C,'. �.�c!b;.��,.4�.J�jl.���i{4yv:4ri:I.�4�,'pa?�;:'�,•'�''g'���% :•' ;� •�}�S
Y'l R •'�:!!',c "94-;.%.t.'..... ,�.' `
Name
F2s�N1--i ST4!-l!oC"c �3�+cX��Z'rcS We.Gk-Et-tn—sGTS i P.G .
Address
SEZO. ) Su tTE 4-30
City L dK-G dDSt.ekeGC�+C7 i State G7 ccot-{ Zip 9.7 43`�
Contact Person Phone Fax
L
L. cx.���t-1 c.�t2k -eta H C�'�)(070•n23 4- C=x�(c7Q.4232
LEGAL DESCRIPTION
C.51-4 c=tL
Please Complete Reverse Side
rt °S° ,A;,, .�'�,, 7o Existing Use p E'rn„\` Proposed Use r... [c.tL-
Permit includes: (*Building 0 Plumbing 0 Mechanical 0 Other
Type of Work: 0 Residential 0 New Z Remodel 0 Number of Units 0 Deck
0 Commercial 0 Addition 0 Garage 0 Shed 0 Other
Enter 1st Floor'Floor 5,OGsp sq ft 2nd Floor sq ft 3rd Floor eq ft Existing Floor Area ' C5C5 J sq ft
Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area S,[xj€=p eq ft
Water Availability 1. Sewer Availability IA, On-Site Septic System Availability 0 Project Valuation $ I3r�cse•-
Zoning Ges1-1•1-"t.. sat-l'°>. C rroc.. I Lot Size %L,4 6..G4Ria'"S Existing Bldg Valuation 8'Lz7S1g4<✓
—
f' 'y'rprgi: •AIrM 'X'i xRr
Name Address
City State Zip
la !-:.y "� a:a.: :iikhex .
Contractor Name Address
City State Zip
Contact Phone Fax
License f _Expiration Date Verified 0 Yes 0 No
', vGMO
ow,
Contractor Name Address
City State Zip
Contact Phone Fax
License if • Expiration Date Verified 0 Yes 0 No
`; :. `.,,5:::sg:•`
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Washers Drinking Fountains Other
Showers Electric Water Heaters Sumps
Lavatories Washing Machine Drains k ti9"fAMna 1s
�"' ` °''• $ � '•* • .. :�•€• MECHANICAL EVALUATION ONLY $
..-'...A...,..
Fuel Type(electrlc%other) Gas Dryer Air Handling < . 10,000 CFM 16-30 Tons
Length of Gas Piping Range Alr 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
Wood Stoves r':2 'ra'•^ .`x% :;c«h�: z:^:',<N"x:
BBQ's 3-15 Tons �f�OtO�f�`ti.{\�f>`47U.t�z�a�`,`�3';:x>� _...<..,
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 petfotmm 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:
9Ut➢M.An,
aevwo a/26/0 7