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WAY APPL/CAT/ON #: PLEASE PRINT �r 4L C )LN 02�� SITE LOCATION Address -3 3 c1 Fq 19 �� A, I s w Tenant known)1 J 6 y 1_11( - Lot # Assg sor's,T x. f�2 -16�4 �' ' v� c11 � �S.ld Build'ng/1erSn1 z- D Ades 10 11 City 3104 , � State ,It�l ip 600,5 Phone 3 3.c/- 2Z-0— Nature '5Nature of Work pi t,ce pozi-iciD ✓ wJri c 4 l-L� APPLICANT ............. Name (F,M,L) Address City State Zip Contact Person Day Phone Other Phone Fax BUILDING CONTRACTOR d 3 G -erm i Company Name Address City State Zip Contact Person Phone Fax Contractor's # (card must be presented) Expiration Date Verified ❑ Yes ❑ No ARCHITECT Naml /n .67 E:3_1Ass,oc,.., . Address5 �24 S Iv 5.4 Poi �.D City .,f_-f� pi''� ri, State V Zip .6 00 3 Contact Per on P•+n- • Fax LEGAL DESCRIPTION e� F-1T&- -fED Please Complete Reverse Side CD0492(Rev 4/931 l ► . StRUCTURE •stin Use , u L,_K7C 1.. aoposed Use Permit includes: Building ❑ Plumbing Mechanical ❑ Other t Type of Work: ❑ Residential 0 New 0 Remodel 0 Number of Units ❑ 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 9 r /q4 sq ft Area Basement sq ft Decks sq ft Garage sq ft Proposed Total Area N/ sq ft f83C, Water Availability 0 Sewer Availability ❑ On-Site Septic System Availability ❑ Project Valuation $ I S CDO Zoning -7 25•7 Z-©a 4 Lot Size "IS. LTJ 14-b_V Existing Bldg Valuation $ )lI11 400 LENDER, Name Address City State Zip . ........ ... ............................. .... . ..................................... MECHANICAL CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No PLUMBING CONTRACTOR Contractor Name Address City State Zip Contact Phone Fax License # Expiration Date Verified 0 Yes 0 No .... ... ....................... PLUMBING FIXTURE COUNT Water Closets Sinks Urinals Lawn Sprinklers Bathtubs Dish Washers Drinking Fountains Other Showers Electric Water Heaters Sumps Lavatories Washing Machine Drains Total Fixture Count MECHANICAL UNIT COUNT MECHANICAL VALUATION 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 BBQ's Wood Stoves 3-15 Tons Total Unit Count LDISCLAIMER: 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 inc rred 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 su• clai arises out of the relia ] e of the City,including its officers and employees,upon the accuracy of the information supplied to the City as a part of this application. 1 ^'/� q‘-.2 Owner/Agent: Date: ! 13 - ---— . .... , a ink_. - ,,,,, g g : ....= eq. r.,.................................. ..•00.0...0-A.0....0,00,,00,0.0.0000,00.,,m0+NAITY411010•4•1111M11.......V.," lip.I a.1 0.y•YowdP. 41 '— ••.!....„- ',.:Z,.,.... ...,:. 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Ca, 4,4 ..', , = *, CD C3 CM' C3 73 CM ...., 1S-- .,. ,....., ...... • SET•B•ACKS •&FOOTINGS Date S—"l.P'- /2S By/A FOUIa DATION �II►AL(S • Date By PLUMBING CaRQUNC)Wf3FtK. Date By ................................................................................. .................................................................................. .............................................I................................... UNDERFLOOR FRAMNG Date By SHEAR.WALLS • Date By PLUMBING ROUGH-IN Date By .................................................................................. ............................. ............. ............. .................. GAS.PIPING:.: Date By MECHANICAL ROUGH-IN Date By MECHANICAL (OTHERI Date By .................................................................................. ................................................................................... FRAMING Date By • .................................................................................. ............................................................................. ........... ........................... .................................. INSULATION:;: Date By GWB - 1ST LAYER Date By GWB - 2ND LAYER Date By SUSPENDED CEILING. Date By PLANNING FINAL Date By ENGINEERING FINAL; Date By FIRE FINAL Date By BUILDING FINAL Date jQ—(:?� By OTHER Date By OTHER Date By CD0193