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SET(Ar:KS& FOOTINGS
Date By
FOUNDATION WALLS
Date By
PLUMBING::GROUN DWORK
Date By
UNDERFLOOR:FRAMING
Date By
SHEAR WAILS
Date By
PLUMBING ROUGH-IN
Date By
GAS.;PIPING
Date By
MECHANICAL ROUGH-IN
Date By
MECHANICAL (OTHER)
Date By
FRAMING
Date By
•
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Date By •
GWB - 1ST LAYER
Date By
GWB 2ND AYER
Date By
SUSP.ENDED CEILINIG
......................................................
Date By
PLANNING FINAL
Date By
ENGINEERING FINAL
Date By
•
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Date By
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By /.,
OTHER
Date By
OTHER
Date By
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BUILDING DIVISION
33530 First Way South
ti;c1E_rzFri_ Federal Way,WA 98003
(253)661-4000
Fax(253)661-4129
APPLICATION FOR BUILDING PERMIT
CITY OF vvnr
PLEASE PRINT BUILOIN�I�aRT10N # ►"LD 5 b c I
1 V
�O
w
:sAddress �?u7
• `I1-k <, Pr
Tenant(if known) Lot# Assessor's Tax#
Building Owner's NameAddress
Yvl Rj d�lcr�-Rt�iaT(ft, �jZS k
City � — State 1".14" Zip 5 E3Cci `s Phone e{ZS—'en3 'ZSZx).
Nature of Work S( s'1\ tV-- k.v?,2()4 (1/1 ,4\-/C >.
eGf: i(Ae7e (4 1)pow (6 C) att p hmst
Name (F,M,L)Ci ez5 2A ,m
Address irveitF 55114 -kktric-(z7
City 45t-(.tvtYr._ State (- Zip 06°6 /S5�
Contact I',er n DayPhone• 373 766. Other Phone Fa 7 2 pO
�ti
LIC # �P
Y BUSINESS
FEDERAL WA LICENSE
Company Name
�k t\ZV CTQ
Address 2 4.4\I Z.Sk Q
c3€ .4 33,?,_ `
C�•ty L(.� ( J State L4A-- Zip5'&2 1 l,�
Contact Person P 7ne"-'37 J /7d Fa z.S--•373 ' , Sc)c
Contractor's # (card must be presented) Expirati Dike Verified ❑ Yes 0 No
� ak v '7 0 (4?MI/50.
............................................................................................
...........................................................................................
............................................................................................
............................................................................................
AI C 107.4V ' >[> >`: <> ` >> >': > s> > << <_
Name4^11—Sc-t-k ' A ,
Address %Hi , �7 I) n �"T
City r1 ,►`� State ("4"._ Zip‘10/01 ,
Contact Personp. �12a1Contca•ac •L23 0353 FZa .223 l0,
LEGAL DESCRIPTION
Please Complete Reverse Side
43. Lai
r
Existing Use 2�L
Proposed Use
.may, fL.-
Permit includes: Building 0 Plumbing 0 Mechanical ❑ Other
Type of Work: 0 gesidential 0 New 0 Remodel 0 Number of Units 0 Deck
,(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 $ .7 too.
Zoning M. I Lot Size Existing Bldg Valuation $
.iMii........ .................................... ilii ......................
............................................................. ........................
............... ...................................................................
............................................................. ........................
............... ...................................................................
............................................................. ........................
ENDER SEliii`.: >€«<?': «<?: ««<` :;<9<>``E`.<<:::
Name Address
City _State Zip
...................................::::::............................................. :i:
>s:<:>::>::>::>::>:::
Contractor Name Address
r''
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes 0 No
.............................................. ..... ......................
Pt UNIBINMC:ONXRACTORNENNEM
Contractor Name Address
City State Zip
Contact Phone Fax
License # Expiration Date Verified 0 Yes ❑ No
.. ...y.,.'.y.[.�.y..�.y...�.(.x../.`F.:.�.!. �.Y.:.!.�.y..�}...�j.�.+.►.}.....t.i............................ .
AVM B.IISl7'F:`I/4:k: !Il�ii�COVNT: <<><> >>
Water Closets Sinks Urinals Lawn Sprinklers
Bathtubs Dish Wash rs Drinking Fountains Other
Showers Electric Wat Heaters Sumps
Lavatories Washing Machine Drains Total fixture Count
.................... ..................................... ......................
.... .................. .............................. .. ........................
...........................................................................................
MECHANICAL C EVALUATION ONLY $
Fuel Type (electric/other) Gas Dr -r Air Handling < = 10,000 CFM 15-30 Tons •
Length of Gas Piping 'ang- Air Handling > = 10,000 CFM 30-50 Tons
Furn <100K BTUs Ga- Lo; Unit Heater 50+ Tons
Furn >100 BTUs F. • 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 kncwlcdge,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 incurre' 's vestig. .. .r. -nse 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. -s out• ance of the c y,including its officers and employees,upon the accuracy of the information supplied to city a part of this application.
Owner/Agen ��i� Date: l� ��
Ir
BUILDING.APP
REVISED 8128/97
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